Return hospital visits and morbidity within 60 days after day surgery: a retrospective study of 18,736 day surgical procedures.
BACKGROUND
As day surgery includes more extensive procedures focus should be put on late outcome. The frequency of day surgery-related return visits and the associated morbidity were examined to identify suitable indicators of quality.


METHODS
From two centres, 16,048 patients underwent 18,736 day surgery operations including 4,829 surgical abortions. Patients were retrospectively analysed for contacts to Danish hospitals within 60 post-operative days and the associated morbidity and mortality. Data were obtained from the Danish National Patient Registry and the National Causes of Death Registry. Patient records were studied to validate contacts as being definite, likely, possible or not related.


RESULTS
Altogether 113 patients (not including the surgical abortions) were readmitted to hospitals with 117 complications definitely or likely related to day surgery. The most common complications were haematomas or haemorrhage (0.40%) and infections (0.29%). Morbidity after the two most common procedures, hernia repair and knee arthroscopy, was observed in 1:39 patients and 1:220 patients, respectively. More serious complications included four patients with septic arthritis of the knee and six patients with venous thromboembolism. After surgical abortion, pelvic inflammation and bleeding were observed in 3.1% and 2.2%, respectively, with centre differences. Altogether no myocardial infarctions, central nervous system deficits, pneumonias or deaths were recorded that could definitely or likely be related to day surgery.


CONCLUSIONS
Day surgery in Denmark is a safe practice. Readmission rates, haematomas and wound infections are likely future indicators of outcome quality after day surgery.
Engbaek
J
J
Day Surgery Unit, Department of Anaesthesiology, Herlev University Hospital, Denmark. jeen@herlevhosp.kbhamt.dk
Bartholdy
J
J
Hjortsø
N-C
NC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D002648:Child; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011184:Postoperative Period; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors