Significant reductions in length of stay after carotid endarterectomy can be safely accomplished without modifying either anesthetic technique or postoperative ICU monitoring

We sought to determine whether postoperative length of stay (LOS) and resource utilization could be safely reduced without changing our uniform protocol of performing carotid endarterectomy (CEA) under general anesthesia with postoperative intensive care unit monitoring. We retrospectively reviewed...

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Bibliographic Details
Published in:Stroke (1970) 1999-11, Vol.30 (11), p.2341-2346
Main Authors: ANGEVINE, P. D, CHOUDHRI, T. F, HUANG, J, QUEST, D. O, SOLOMON, R. A, MOHR, J. P, HEYER, E. J, CONNOLLY, E. S
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures
Anesthesia, General
Biological and medical sciences
Cohort Studies
Critical Care
Endarterectomy, Carotid
Female
Health Resources - statistics & numerical data
Hospital Administration
Humans
Laboratories, Hospital - statistics & numerical data
Length of Stay
Male
Medical sciences
Middle Aged
Monitoring, Physiologic
Neurosurgery
Organizational Policy
Patient Discharge
Postoperative Care
Postoperative Complications
Reoperation
Retrospective Studies
Safety
Skull, brain, vascular surgery
Stroke - etiology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
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Summary:We sought to determine whether postoperative length of stay (LOS) and resource utilization could be safely reduced without changing our uniform protocol of performing carotid endarterectomy (CEA) under general anesthesia with postoperative intensive care unit monitoring. We retrospectively reviewed the hospital records of 421 consecutive CEA operations performed during a 3-year period of transition in discharge policy to determine LOS, complications, and resource utilization. We divided operated patients into 3 cohorts: cohort I patients were operated on before a stay reduction policy was instituted (1995, n=171); cohort II patients were operated on after the institution of a single-day-stay policy for selected patients (January to August 1996, n=95); and cohort III patients were operated on after the institution of a universal single-day-stay policy (September 1996 to December 1997, n=155). While significant in-hospital complications leading to increased LOS remained essentially unchanged over time (cohort I: 4.0%; II: 6.3%; III: 3.9%; P=NS), the mean postoperative LOS decreased from 2.6+/-0.3 days in cohort I to 1.6+/-0.1 days in cohort III (P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.30.11.2341