Outcome after day-care surgery in a major teaching hospital.
Outcome has been measured for 6000 consecutive procedures in a major public teaching hospital day surgery unit. The unanticipated hospital admission rate was 1.34% and surgery-related admissions (0.95%) exceeded those related to anaesthesia (0.13%). Perioperative complications related to surgery (1:105) were more frequent than those related to anaesthesia (1:176) and pre-existing medical problems (1:500). Anaesthesia-related complications were more frequent with general anaesthesia (1:114) than with local anaesthesia plus sedation (1:780) or regional anaesthesia (1:180). Recovery times after general anaesthesia were longer than after other anaesthetic techniques but did not correlate with patient age (r = 0.04; P = 0.02) and only weakly correlated with procedure duration (r = 0.21; P < 0.01). At early follow-up, 4.0% of patients had presented to a local medical practitioner and 3.1% to a hospital accident and emergency service, usually for minor problems. Take home analgesia was adequate for 95% of patients and 98.9% were happy with the day surgery service. Day surgery in a teaching hospital can provide satisfactory outcome, with low complication rates, high patient acceptance and low community support requirements after patient discharge.
Osborne
G A
GA
Department of Anaesthesia and Intensive Care, Royal Adelaide Hospital, South Australia.
Rudkin
G E
GE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000523:psychology / Q000706:statistics & numerical data*; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects / Q000706:statistics & numerical data; D000772:Anesthesia, Local / Q000009:adverse effects / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010149:Postoperative Pain / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D013021:South Australia / Q000453:epidemiology; D013997:Time Factors