35. Effect of Inpatient Status in Patients Undergoing Hand Surgery: A Propensity-score Matched Analysis

Abstract

PURPOSE: There has been a rise in outpatient hand surgery as many of these procedures can now be performed under local anesthesia. This study examines postoperative complication differences between outpatient and inpatient hand surgery patients. METHODS: Using the National Surgical Quality Improvement Program Database from 2005 to 2018, all hand surgical CPT codes (26010 - 26952) were queried. Patients were divided into inpatient or outpatient status. A probability score based on demographic and comorbidity characteristics was used to match similar patients for comparison. RESULTS: Overall, 28,830 (90.8%) of patients undergoing hand procedures were outpatient and 2,924 (9.2%) were inpatient. After matching patients by probability score (n = 5,083), inpatients were more likely to be male, underweight, non-White, and have a history of hypertension, cardiac comorbidity, steroid use, and American Society of Anesthesiologists Classification ≥ 3. After further adjustment for these seven variables, inpatients were more likely to experience death (p < 0.001), unplanned reoperation (p = 0.010), unplanned readmission (p < 0.001), and a major complication (p < 0.001). CONCLUSION: Outpatient hand surgery is less associated with death, unplanned reoperation, unplanned readmission, major complications, and minor complications than inpatient hand surgery after controlling for pre-operative variance.