Same-evening discharge after carotid endarterectomy: our initial experience

• Published in: Journal of vascular surgery 2004-03, Vol.39 (3), p.575-577
• Main Authors: Sheehan, Maureen K, Greisler, Howard P, Littooy, Fred N, Baker, William H
• Format: Article
• Language: English
• Subjects: Algorithms; Ambulatory Surgical Procedures - methods; Ambulatory Surgical Procedures - psychology; Attitude; Biological and medical sciences; Endarterectomy, Carotid - methods; Feasibility Studies; Humans; Medical sciences; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2003.09.037

The purpose of this study was to review the initial implementation of a same-evening discharge algorithm for patients undergoing carotid endarterectomy (CEA). We conducted a retrospective review of a prospective database of patients undergoing CEA over 3 years. From January 2000 to December 2002, 207 patients underwent CEA, of which 186 qualified for same-evening discharge. Fifty-nine patients (32%) who qualified were discharged to home the same evening; none had an adverse event after discharge. The most common reason for patients not to be discharged the same evening was exiting the operating room too late (n = 63, 34%). Thirteen patients chose to stay overnight, and 11 patients did not go home secondary to physician choice. None of these patients experienced any adverse sequelae during the overnight stay. Same-evening discharge after CEA is safe and feasible in selected patients. Currently, nearly one third of our patients are discharged within 8 hours of CEA. With appropriate scheduling, patient education, and increasing physician awareness, most patients can be discharged to home the same evening after CEA.