The risk of complications or post-surgery emergency care after orthopedic surgeries at ambulatory surgery centers (ASC) is low, according to a new study.
“Ambulatory surgeries have increased in recent decades to help improve efficiency and cost; however, there is a potential need for unplanned postoperative admission, clinic visits, or evaluation in the emergency department,” the researchers wrote in the study, “Unplanned Emergency Visits and Admissions After Orthopaedic Ambulatory Surgery in the First 2 Years of Operation of a University Ambulatory Surgery Center”, published online December 17, 2020 in The American Journal of Sports Medicine.
To better understand the frequency, reasons and factors influencing hospitalizations, return to clinic and or emergency department visits within 24 hours of ambulatory surgery, they collected data on the first two years of operation of a university sports medicine ambulatory surgery center.
They hypothesized that the number of emergency department visits would be low and primarily because of pain or postoperative complications.
The retrospective review collected data on operations from between November 2016 and October 2018. The data included age, sex, Current Procedural Terminology code, procedure performed, American Society of Anesthesiologists classification, body mass index, medical history, and tobacco use.
They also gathered data on patients seeking care in the emergency department, inpatient or outpatient setting within the first 24 hours of surgery. The reasons for the visits were categorized into three groups: medical complications, postoperative pain or other postoperative complication.
In the two-year period, a total of 4,650 sports medicine procedures were performed at the university ASC. Of those, 35 patients sought additional care within 24 hours of surgery. The primary reason reported was medical complications (n = 16; 45.7%)
The patients with complications were more likely to be older, to have multiple comorbidities and to have undergone upper extremity procedures. Patients with higher American Society of Anesthesiologists classification scores were more likely to seek additional care (p < .005).
The researchers also discovered a trend toward increased risk of seeking additional care with upper extremity surgery (p =.077).
The researchers wrote, “Orthopaedic procedures performed in an ASC result in a relatively low percentage of patients seeking additional care within the first 24 hours of surgery, consistent with other reports in the literature. Upper extremity procedures, particularly those of the shoulder, may carry an increased risk of requiring medical treatment within 24 hours of surgery. Even in the first 2 years of operation of a university-based ASC, low rates of postoperative complications and unplanned admissions can be maintained.”
