scholarly journals Day-Case Septoplasty and Unexpected Re-Admissions at a Dedicated Day-Case Unit: A 4-Year Audit

2006 ◽  
Vol 88 (2) ◽  
pp. 202-206 ◽  
Author(s):  
Christos Georgalas ◽  
Rupert Obholzer ◽  
P Martinez-Devesa ◽  
G Sandhu
Keyword(s):  
Patient Satisfaction ◽  
Admission Rate ◽  
Day Surgery ◽  
Case Note ◽  
Day Case ◽  
Retrospective Case ◽  
Patient Factors ◽  
Factors Associated ◽  
Septal Surgery ◽  
Submucous Resection

INTRODUCTION Septal surgery has been identified as suitable for day-surgery, but is not widely performed as such. Guidelines for day-surgery state that the unexpected admission rate should be 2–3%. Previous audits have not achieved this figure and septoplasty is not universally considered suitable for day-surgery. We have reviewed practice over 4 years in our institution to identify surgical and patient factors associated with unexpected admission following septoplasty. PATIENTS AND METHODS A retrospective case note based audit of day-case septoplasty procedures reviewed at the end of each year between October 1998 and October 2002. RESULTS A total of 432 septal surgery procedures were performed, comprising 378 septoplasties and 54 submucous resections. Thirty-eight patients were admitted, overwhelmingly because of haemorrhage in the immediate postoperative period, giving an overall admission rate of 8.8% within the first 24 h. Factors associated strongly with re-admission were the use of intranasal splints, the performance of revision surgery, submucous resection (as opposed to septoplasty) and, less so, the performance of additional procedures and the peri-operative administration of diclofenac. There was no correlation between unexpected admission and grade of surgeon, surgical technique or any of the patient factors analysed. CONCLUSIONS The unexpected admission rate of septal surgery performed at our unit is above that recommended for day-case procedures, but is within the range previously published. Patient satisfaction with day-case septoplasty has been shown to be high. We believe that septoplasty should be performed in this setting but there is a significant chance that patients may need admission, and a pathway should be in place for this to occur with minimal disruption to the patient.

Day-case septal surgery under general anaesthesia and local anaesthesia with sedation

1995 ◽  
Vol 109 (7) ◽  
pp. 614-617 ◽  
Author(s):  
V. Srinivasan ◽  
R. B. S. Arasaratnam ◽  
G. A. Jankelowitz
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Admission Rate ◽  
Day Case ◽  
Bleeding Rate ◽  
Septal Surgery ◽  
Submucous Resection

AbstractSeptal surgery (submucous resection and septoplasty) has been performed as a day-case procedure routinely under general anaesthesia and local anaesthesia with sedation at the Ipswich Hospitalsince 1992. The outcome of the day-case septal surgery over a period of 18 months has been audited. A total of 95 cases were operated on of which 48 were under general anaesthesia (GA) and 47 under local anaesthesia (LA) with sedation using midazolam intravenously. The bleeding rate and overnight admission rate were 10.5 and 11.4 percent respectively. The bleeding rate was the same in both GA and LA groups. The combination of local anaesthesia and sedation has been foundto be safe, effective and acceptable to patients. It is concluded that septal surgery is suitable as a day procedure and that local anaesthesia combined with sedation has a definite place ifcarried out properly.

scholarly journals Laparoscopic Cholecystectomy as a Day Surgery Procedure

1996 ◽  
Vol 24 (2) ◽  
pp. 231-236 ◽  
Author(s):  
R. J. Singleton ◽  
G. E. Rudkin ◽  
G. A. Osborne ◽  
D. S. Watkin ◽  
J. A. R. Williams
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Recovery Room ◽  
Admission Rate ◽  
Day Surgery ◽  
Nausea And Vomiting ◽  
Day Case ◽  
Hospital Admission Rate ◽  
Admission Rates ◽  
Surgery Patient ◽  
At Home

Outcome is presented for 40 consecutive laparoscopic cholecystectomies performed in a public teaching hospital day surgery unit. The unanticipated hospital admission rate on the day of surgery was 17.5% (seven patients) and the majority of these (12.5%; five patients) were due to surgery-related considerations. Two other admissions were due to nausea and vomiting. One patient was admitted to hospital on the second postoperative day with nausea and vomiting. Procedure duration for the day cases averaged 98 minutes (SD25; range 60–167). Recovery room times before discharge averaged 272 minutes (SD 58; range 125–365). Each day surgery patient averaged 3.3 postoperative home visits from community nurses. Most patients (94%) mobilized at home by the second postoperative day and 85% resumed normal activities of daily living by two weeks. At follow-up, 25 patients (76%) stated they were happy to spend the first night at home, but seven (21%) would have preferred to remain in hospital for the first postoperative night. Laparoscopic cholecystectomy can be performed successfully as a day–case procedure, but long operating and recovery room times and potentially high admission rates suggest that these factors should be considered in cost equations for day-case management of this procedure.

scholarly journals Depression and Non-modifiable Patient Factors Associated with Patient Satisfaction in an Academic Orthopaedic Outpatient Clinic

2019 ◽  
Vol 477 (12) ◽  
pp. 2653-2661 ◽  
Author(s):  
Breann K. Tisano ◽  
Paul A. Nakonezny ◽  
Bruno S. Gross ◽  
J. Riley Martinez ◽  
Joel E. Wells
Keyword(s):  
Patient Satisfaction ◽  
Outpatient Clinic ◽  
Patient Factors ◽  
Factors Associated

A comparative study of patient satisfaction with day case and in-patient major ear surgery

2006 ◽  
Vol 120 (8) ◽  
pp. 670-675 ◽  
Author(s):  
J R Tysome ◽  
N D Padgham
Keyword(s):  
Patient Satisfaction ◽  
Response Rate ◽  
Day Surgery ◽  
Postal Questionnaire ◽  
Day Case ◽  
Cross Sectional Survey ◽  
Ear Surgery ◽  
Cross Sectional ◽  
Level Of Satisfaction ◽  
Case Basis

Introduction: Major ear surgery can be safely performed on a day case basis (i.e. six hour stay). This study aimed to ascertain whether patients had the same level of satisfaction and speed of recovery following major ear surgery when it was performed as a day case compared with performance as an in-patient procedure.Method: A cross-sectional survey, by postal questionnaire, of patient satisfaction with day case and in-patient major ear surgery was carried out with 158 patients. Comparisons were made between the responses of the two groups.Results: The response rate was 71 per cent. Patients returned to work significantly sooner following day surgery (p < 0.025) but felt their operation to be of significantly more benefit following in-patient surgery (p < 0.05).Conclusions: Patient satisfaction following day case major ear surgery is as good as that following in-patient surgery. This has supported the expansion of this service in our unit.

scholarly journals Day-Case Rigid and Flexible Ureteroscopy

2007 ◽  
Vol 89 (5) ◽  
pp. 526-528 ◽  
Author(s):  
EJ Bromwich ◽  
R Lockyer ◽  
SR Keoghane
Keyword(s):  
Clearance Rate ◽  
Admission Rate ◽  
Day Surgery ◽  
Prophylactic Antibiotics ◽  
Flexible Ureteroscopy ◽  
Safe Procedure ◽  
Unplanned Admission ◽  
Day Case ◽  
Stone Clearance ◽  
Inflammatory Drugs

INTRODUCTION The aim of this study was to evaluate the feasibility of rigid and flexible ureteroscopy as a day-surgery procedure. PATIENTS AND METHODS All patients requiring elective ureteroscopy from March 2004 were considered for a day-surgery procedure. The standard day-surgery exclusions existed but there were no urological criteria for exclusion. A single consultant urologist performed or supervised all procedures. RESULTS A total of 64 patients underwent 50 rigid and 14 flexible procedures. Six diagnostic ureteroscopies were performed. There was a 96% stone clearance rate. Five patients required an unplanned admission within the first 2 weeks' postoperatively. Three of these patients were admitted on the day of surgery, two for pain and one for social reasons. Two patients were admitted at 24 h and 48 h, respectively, for urinary retention. CONCLUSIONS Ureteroscopy, both rigid and flexible, is a safe procedure for the day-surgery setting. Routine use of prophylactic antibiotics, intravenous non-steroidal anti-inflammatory drugs resulted in an acceptable re-admission rate.

Major ear surgery in a paediatric day care unit

2002 ◽  
Vol 116 (10) ◽  
pp. 791-793 ◽  
Author(s):  
R. G. Rowlands ◽  
R. Harris ◽  
J. Hern ◽  
J. R. Knight
Keyword(s):  
Outcome Measure ◽  
Admission Rate ◽  
Day Surgery ◽  
Unplanned Admission ◽  
Day Case ◽  
Ear Surgery ◽  
The Usa ◽  
Unplanned Admissions ◽  
Mastoid Surgery ◽  
Case Basis

Abstract Traditionally major ear surgery in children has been regarded as an in-patient procedure. Evidence from the USA for adults, however, concludes that it is both safe and effective to perform many major ear procedures as day cases. We have been carrying out major ear operations on children as day cases routinely for six years in a dedicated children’s day unit and examined our data to find out whether it was both safe and feasible to perform major ear surgery in children on a day-case basis. As our main outcome measure we used the rate of unplanned admissions.We found that the unplanned admission rate for surgery, excluding mastoid surgery, was 6.7 per cent and that procedures such as myringoplasty, ossiculoplasty, bilateral pinnaplasty, meatoplasty and tympanotomy with excision of cholesteatoma, were eminently suitable for day surgery.

scholarly journals Prevalence of Balance Impairment and Factors Associated with Balance among Patients with Stroke. A Cross Sectional Retrospective Case Control Study

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 320
Author(s):  
Fayaz Khan ◽  
Mohamed Faisal Chevidikunnan
Keyword(s):  
Case Control Study ◽  
Binary Logistic Regression ◽  
Berg Balance Scale ◽  
Case Control ◽  
Knee Extensors ◽  
Retrospective Case ◽  
Cross Sectional ◽  
Balance Impairment ◽  
Factors Associated ◽  
Control Study

Stroke is a major cause of disability worldwide, and balance impairments are common disabling factors in patients with stroke, leading to falls. Thus, the study objectives were as follows: (i) To find the prevalence of balance impairment among patients with stroke. (ii) To find out the factors associated with balance impairment in patients with stroke. This cross-sectional retrospective case control study involved eighty-one post stroke patients with a mean age of 58.36 ± 14.06, recruited from six hospitals, who underwent an assessment of balance, walking speed, depression and isometric strength of the ankle and knee. These patients were later categorized into subjects with good balance (<45) in the Berg balance scale (BBS) and those with poor balance (≥45), as cases and controls, to assess the factors associated with balance impairment using binary logistic regression. The prevalence of balance impairment among patients with stroke was 48.1%. The reduction in power of knee flexors (OR = 0.858), knee extensors (OR = 0.880) and ankle dorsiflexors (OR = 0.820) was found to be significantly associated with balance impairment, along with speed (OR = 1.187 (95% CI = 1.100, 1.280)), depression (OR = 1.331 (95% CI = 1.055–1.679)) and activities of daily living (OR = 0.313 (95% CI = 0.150–0.650)). In summary, around half of the patients with stroke exhibited balance impairments, with females being more prone.

scholarly journals Mortality in Escherichia coli bloodstream infections: a multinational population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa C. MacKinnon ◽  
Scott A. McEwen ◽  
David L. Pearl ◽  
Outi Lyytikäinen ◽  
Gunnar Jacobsson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Mortality Rate ◽  
Case Fatality ◽  
Population Based ◽  
Day Case ◽  
Fatality Risk ◽  
E Coli ◽  
Factors Associated ◽  
Case Fatality Risk ◽  
Age And Sex

Abstract Background Escherichia coli is the most common cause of bloodstream infections (BSIs) and mortality is an important aspect of burden of disease. Using a multinational population-based cohort of E. coli BSIs, our objectives were to evaluate 30-day case fatality risk and mortality rate, and determine factors associated with each. Methods During 2014–2018, we identified 30-day deaths from all incident E. coli BSIs from surveillance nationally in Finland, and regionally in Sweden (Skaraborg) and Canada (Calgary, Sherbrooke, western interior). We used a multivariable logistic regression model to estimate factors associated with 30-day case fatality risk. The explanatory variables considered for inclusion were year (2014–2018), region (five areas), age (< 70-years-old, ≥70-years-old), sex (female, male), third-generation cephalosporin (3GC) resistance (susceptible, resistant), and location of onset (community-onset, hospital-onset). The European Union 28-country 2018 population was used to directly age and sex standardize mortality rates. We used a multivariable Poisson model to estimate factors associated with mortality rate, and year, region, age and sex were considered for inclusion. Results From 38.7 million person-years of surveillance, we identified 2961 30-day deaths in 30,923 incident E. coli BSIs. The overall 30-day case fatality risk was 9.6% (2961/30923). Calgary, Skaraborg, and western interior had significantly increased odds of 30-day mortality compared to Finland. Hospital-onset and 3GC-resistant E. coli BSIs had significantly increased odds of mortality compared to community-onset and 3GC-susceptible. The significant association between age and odds of mortality varied with sex, and contrasts were used to interpret this interaction relationship. The overall standardized 30-day mortality rate was 8.5 deaths/100,000 person-years. Sherbrooke had a significantly lower 30-day mortality rate compared to Finland. Patients that were either ≥70-years-old or male both experienced significantly higher mortality rates than those < 70-years-old or female. Conclusions In our study populations, region, age, and sex were significantly associated with both 30-day case fatality risk and mortality rate. Additionally, 3GC resistance and location of onset were significantly associated with 30-day case fatality risk. Escherichia coli BSIs caused a considerable burden of disease from 30-day mortality. When analyzing population-based mortality data, it is important to explore mortality through two lenses, mortality rate and case fatality risk.

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