Causes of unplanned admission after orthopaedic procedures in ambulatory surgery

• Published in: Revista española de cirugía ortopédica y traumatología 2020-01, Vol.64 (1), p.50-56
• Main Authors: Jiménez Salas, B., Ruiz Frontera, M., Seral García, B., García-Álvarez García, F., Jiménez Bernadó, A., Albareda Albareda, J.
• Format: Article
• Language: English
• Subjects: Cirugía ambulatoria; Cirugía ortopédica y traumatología; Ingresos no deseados; Orthopaedic surgery; Outpatient surgery; Unplanned admissions
• ISSN: 1988-8856; 1988-8856
• DOI: 10.1016/j.recote.2019.11.004

Orthopaedic procedures performed in Day Surgery Units provide important advantages which disappear when patients require admission when postoperative recovery is not as expected. The aim of this study was to analyse the reasons for unplanned hospital admissions after orthopaedic procedures in a Day Surgery Unit and their relationship between variables such as patient age, anaesthetic risk and technique, procedure or duration. Ambispective cohort study of 5085 patients who underwent surgical orthopaedic procedures between 1995 and 2017. Thirty-nine variables provided by the Unit’s database were analysed. The database was opened on the day of admission and closed the 30th postoperative day. Of the patients, 98.2 % were discharged from the Unit. Seventy- four, 1.5 % required overnight admission. This percentage showed significant differences in relation to the type of procedure, type of anaesthesia and duration, which conditioned overnight admission due to inadequate postoperative pain management, nausea or wound complications. Seventeen patients, .3 %, required readmission after discharge due to complications that arose at home, such as wound infection, which was the most common. Unplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge. Los procedimientos de Cirugía Ortopédica y Traumatología (COT) realizados en Unidades de Cirugía Mayor Ambulatoria (CMA) ofrecen importantes ventajas que desaparecen cuando la recuperación postoperatoria no es la esperada y los pacientes precisan ingresar. El objetivo de este estudio es analizar las causas de ingresos no deseados tras intervenciones quirúrgicas de COT en una Unidad de CMA en relación con variables como edad, riesgo anestésico, tipo de anestesia, procedimiento o duración. Estudio de cohorte ambispectivo sobre 5085 pacientes intervenidos desde 1995 a 2017. Se analizaron 39 variables proporcionadas por la base de datos de la Unidad que se abre al ingreso en la misma y se cierra el día 30 postoperatorio. El 98.2% de los pacientes fueron dados de alta de la Unidad. Precisaron ingresar 74, 1.5%. Este porcentaje demostró diferencias significativas en relación al tipo de procedimiento, tipo de anestesia y duración, que con