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Outcomes in day surgery

Shnaider, Ilia; Chung, Frances

Current Opinion in Anaesthesiology: December 2006 - Volume 19 - Issue 6 - p 622–629
doi: 10.1097/ACO.0b013e328010107e
Ambulatory anaesthesia

Purpose of review: 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.

Recent findings: 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.

Summary: 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.

Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada

Correspondence to Dr Frances Chung, Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, McL 2-405, 399 Bathurst St., Toronto, Ontario, Canada M5T 2S8 Tel: +1 416 603 5118; fax: +1 416 603 6494; e-mail: frances.chung@uhn.on.ca

© 2006 Lippincott Williams & Wilkins, Inc.