Safety and Readmission in Pediatric Ambulatory Surgery in a Tertiary Hospital.

Assem M Alghamdi,Moath A Alowairdhi,Saud A Aljadaan,Rumyyan A Alrumyyan,Mohammed A Alhussain,Saif A Alsemairi

doi:10.7759/cureus.21274

Assem M Alghamdi, Moath A Alowairdhi + Show 4 more

Open Access

https://doi.org/10.7759/cureus.21274

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Abstract

Objectives: To assess the safety and outcome of pediatric ambulatory surgery by measuring the rate of complications and readmission and identifying common risk factors for complications and readmission.Materials and methods: A cross-sectional study was conducted at King Abdullah Specialist Children’s Hospital (KASCH), Riyadh, Kingdom of Saudi Arabia, using the BESTCare 2.0 Health Information System (SKHIC, Riyadh, Saudi Arabia). All cases admitted under the pediatric ambulatory surgery unit from June 2015 to May 2018 were included. We reviewed 462 medical charts and recorded the variables of age, sex, American Society of Anesthesiologists (ASA) classification, complications, and readmission within one month of the surgery. SPSS (IBM Corp., Armonk, NY, USA) was used for data analysis. Associations between exposure variables (e.g., age, duration of surgery) and the outcome variables (e.g., rate of readmission and complications) were measured using the Chi-square test for categorical variables, the T-test and analysis of variance (ANOVA) for numerical and categorical variables, and logistic regression for multiple variables to control confounding variables.Results: Approximately, 3.5% of the pediatric ambulatory surgery cases required readmission, and 10.6% of the patients had complications with zero mortality. All the variables had no significant association either with the readmission or complications (p > 0.05), except for the duration of surgery in minutes which was associated with complications (OR 1.006, 95% CI, 1.000-1.012, P = 0.035).Conclusion: Among pediatric ambulatory surgery cases, the mortality rate is 0%, with low complications and readmission rates. Also, the longer the surgery, the higher the risk of complications.

Highlights

Ambulatory surgery can be described as surgery that is performed on outpatients who are discharged on the same day [1]
All the variables had no significant association either with the readmission or complications (p > 0.05), except for the duration of surgery in minutes which was associated with complications
The low rate of adverse events or complications during the intraoperative or immediate postoperative periods further justifies the rapid growth of ambulatory surgery and its potential to be the standard of care [4,5]

Summary

Introduction

Ambulatory surgery can be described as surgery that is performed on outpatients who are discharged on the same day [1]. Ambulatory surgery has several advantages, including lower costs, increased provider productivity, and increased patient convenience [2]. Ambulatory surgery cases have been rapidly increasing because of their low percentage of complications, quality in various aspects, and lower cost, approaching 30% of Medicare surgical expenses in 2014 [4,5]. There had been a few readmission cases to the hospital for several reasons, and most of them did not have major complications [1]. A readmission is defined as a subsequent inpatient admission to an acute care facility occurring within 30 days of the discharge date of an eligible index admission [6]

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