title: Discharge on the first postoperative day after elective carotid endarterectomy.
abstract: BACKGROUND
  Medical complications may prolong the hospital stay after elective carotid endarterectomy (CEA). We prospectively assessed the social and medical feasibility and safety of patient discharge on the first postoperative day after elective CEA and unplanned readmissions.
  
  
  METHODS
  Between June 2011 and January 2012, 57 consecutive patients scheduled for elective CEA were enrolled with the aim of discharge on the first postoperative day if there were no medical contraindications and on the condition that the patient should not be left alone during the first day and night at home. CEA was carried out under local or general anesthesia. After discharge, the patients were contacted to ascertain the occurrence of arterial hypertension, cerebral hyperperfusion, focal cerebral ischemia, or hospital readmission.
  
  
  RESULTS
  Sixty-two CEA were carried out in 57 patients (33 men and 24 women ranging in age from 51-89 years). The indications for CEA were: asymptomatic high grade stenosis in 27, hemispheric transient ischemic attack in 12, amaurosis fugax in 6, recovered stroke in 16, and nonlateralizing signs in 1. There were no cases of perioperative stroke or death. Discharge on the first postoperative day was achieved in 45 cases (73%). In 15 cases (24%), discharge was on the second postoperative day because of the absence of a relative (12 cases) or for medical reasons (3 cases). Discharge was on day 3 in 1 case, and on day 10 in another, both for medical reasons. No cases of severe arterial hypertension, stroke, mortality, or readmission for reasons related to the CEA procedure were recorded up to postoperative day 30.
  
  
  CONCLUSIONS
  In this study, the majority of patients undergoing elective CEA were discharged safely on the first postoperative day. Social reasons, rather than medical reasons, underlied most cases of later discharge. There were no unplanned readmissions for complications of CEA.
authors.affiliation: Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium. Electronic address: pierre.vandenbrande@skynet.be.
authors.forename: Pierre
authors.initials: P
authors.lastname: Van den Brande
authors.affiliation: Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Isolde
authors.initials: I
authors.lastname: Van Heymbeeck
authors.affiliation: Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Erik
authors.initials: E
authors.lastname: Debing
authors.affiliation: Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Aerden
authors.affiliation: Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Karl
authors.initials: K
authors.lastname: von Kemp
authors.affiliation: Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Leslie
authors.initials: L
authors.lastname: Moerman
authors.affiliation: Department of Anesthesiology, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Chris
authors.initials: C
authors.lastname: Verborgh
authors.affiliation: Center for Outcome Research, Universitair Ziekenhuis Brussel, Brussels, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Haentjens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D017558:Elective Surgical Procedures; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012931:Social Environment; D013997:Time Factors; D016896:Treatment Outcome