Unplanned readmission after ocular trauma ambulatory surgery: A retrospective study of the Zhongshan Ophthalmic Center.

Abstract

Ambulatory surgery (AS) has become common in recent years. This study explored the causes of unplanned readmission after AS and the trends in the rate of unplanned readmission in the Ocular Trauma Department of Zhongshan Ophthalmic Center. We collected information on patients who underwent AS from 1 January 2015 to 31 December 2017, summarized the causes of ambulatory hospitalization, and analysed the type of initial surgical procedure and the reasons for 31-day unplanned readmission. The Ocular Trauma Department started to perform AS in around mid-2015, and we collected information on patients who underwent ambulatory pars plana vitrectomy (APPV) from 1 January 2016 to 31 December 2017 to explore the predictive factors for the 31-day unplanned readmission of APPV patients. In 2015, 2016, and 2017, a total of 3443 patients underwent AS, among whom the three most common causes of ambulatory hospitalization were eye wall and appendages injury, aphakia, and silicone oil-filled eye. Of the 3443 patients, 32 returned for 31-day unplanned readmission, a readmission rate of 0.93%. The most common surgery (34.4%, 11/32) that resulted in unplanned readmission was pars plana vitrectomy (PPV). The major reasons for unplanned readmission were retinal detachment (RD) (34.4%, 11/32) and high intraocular pressure (HIP) (18.8%, 6/32). There were 860 patients who underwent APPV from 1 January 2016 to 31 December 2017, among whom 10 needed 31-day unplanned readmission, and the readmission rate of APPV for ocular trauma in 2016 and 2017 was 1.16%. Length of procedure (P<0.05) and use of silicone oil filling (P<0.05) were significantly related to the risk of unplanned readmission for APPV surgery. It is generally safe to perform AS on patients with ocular trauma. However, longer operative times and silicone oil filling increase the risk of unplanned readmission for APPV surgery.