Outcomes in day surgery.
OBJECTIVE
To summarize and examine the updated published results on the outcome measures that can be used to assess the quality of ambulatory surgery and anesthesia.


RESULTS
Major morbidity and mortality following ambulatory surgery is exceedingly low. Cancellations and delays may have a negative impact on the patients, healthcare personnel and the organizations. Minor cardiovascular adverse events are the most common intraoperatively and are associated with preexisting cardiovascular diseases and elderly patients. Respiratory events postoperatively are associated with obesity, smoking and asthma. Also, pain is a common cause for longer postoperative stay, unanticipated admission and readmission. Postoperative nausea and vomiting occurs in 30% of patients and strongly affects patient satisfaction. Furthermore, prolonged stays are mainly caused by surgical factors, or minor symptoms like pain or nausea. Surgical factors are also the main causes of unanticipated hospital admission. The type of surgery and the 24 h postoperative symptoms may affect the degree of return to daily living function. Also, patient satisfaction affects the outcome of healthcare and the use of healthcare services.


CONCLUSIONS
Ambulatory surgery, as currently practiced, provides quality care that is cost-effective. Minor adverse events such as pain and postoperative nausea and vomiting are still common, and improvement could be targeted in these areas.
Shnaider
Ilia
I
Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Chung
Frances
F
D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D000700:Analgesics / Q000009:adverse effects; D000762:Anesthesia Recovery Period; D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000401:mortality; D000779:Anesthetics, Local / Q000009:adverse effects; D019985:Benchmarking; D002318:Cardiovascular Diseases / Q000209:etiology; D006760:Hospitalization; D006801:Humans; D008136:Longevity; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D010359:Patient Readmission; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced; D019984:Quality Indicators, Health Care; D020127:Recovery of Function; D012140:Respiratory Tract Diseases / Q000209:etiology; D016896:Treatment Outcome
D000700:Analgesics; D000779:Anesthetics, Local