Safety of emergency, elective and day case operating during the winter period at East Suffolk and North Essex NHS Foundation Trust: lessons from the outcomes of 4,254 surgical patients from the first COVID-19 wave

2021 ◽  
Vol 103 (7) ◽  
pp. 478-480
Author(s):  
S Parikh ◽  
L Cooper ◽  
W Matthews ◽  
M Khan ◽  
S Syed ◽  
...  
Keyword(s):  
Evidence Base ◽  
Surgical Patients ◽  
Perioperative Outcomes ◽  
Winter Period ◽  
Limited Evidence ◽  
Day Case ◽  
Emergency Admissions ◽  
Day Case Surgery ◽  
Case Surgery ◽  
Regular Review

Background There is limited evidence on perioperative outcomes of surgical patients during the COVID-19 pandemic to inform continued operating into the winter period. Methods We retrospectively analysed the rate of 30-day COVID-19 transmission and mortality of all surgical patients in the three hospitals in our trust in the East of England during the first lockdown in March 2020. All patients who underwent a swab were swabbed on or 24 hours prior to admission. Results There were 4,254 patients and an overall 30-day mortality of 0.99%. The excess surgical mortality in our region was 0.29%. There were 39 patients who were COVID-19 positive within 30 days of admission, 12 of whom died. All 12 were emergency admissions with a length of stay longer than 24 hours. There were three deaths among those who underwent day case surgery, one of whom was COVID-19 negative, and the other two were not swabbed but not suspected to have COVID-19. There were two COVID-19 positive elective cases and none in day case elective or emergency surgery. There were no COVID-19 positive deaths in elective or day case surgery. Conclusions There was a low rate of COVID-19 transmission and mortality in elective and day case operations. Our data have allowed us to guide patients in the consent process and provided the evidence base to restart elective and day case operating with precautions and regular review. A number of regions will be similarly affected and should perform a review of their data for the winter period and beyond.

Theatre procedures and prophylaxis

2011 ◽  
Author(s):  
David J. Leaper
Keyword(s):  
Deep Vein Thrombosis ◽  
Bowel Preparation ◽  
Evidence Base ◽  
Hiv And Aids ◽  
X Rays ◽  
Day Case ◽  
Day Case Surgery ◽  
Vein Thrombosis ◽  
Case Surgery ◽  
Deep Vein

Theatre discipline 30Patient care in operating theatre 32Day case surgery 34Evaluation of X-rays in surgery 36Prophylaxis of deep vein thrombosis 38Antibiotic prophylaxis 40Bowel preparation 42HIV and AIDS precautions 44There are many time-honoured procedures in theatre which do not have an accepted evidence base. Nevertheless it would flaunt danger to disregard them, particularly as we currently enjoy the lowest figure of morbidity and mortality despite operating on a sicker and old cohort of patient. There are some downsides; the increase of emergent and resistant organisms such as ...

scholarly journals Comparison of Propofol and Thiopentone Anaesthesia (with Special Reference to Recovery Characteristics)

1987 ◽  
Vol 15 (4) ◽  
pp. 389-393 ◽  
Author(s):  
W. M. Weightman ◽  
M. Zacharias
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Day Case ◽  
Early Recovery ◽  
Day Case Surgery ◽  
Pain On Injection ◽  
High Incidence ◽  
Case Surgery ◽  
Repeated Doses ◽  
The Mean

Thiopentone and propofol were used for the induction and maintenance of anaesthesia in unpremedicated patients undergoing minor gynaecological procedures. There were no significant differences in the induction and maintenance characteristics except for a high incidence of pain on injection and a greater fall in the mean systolic blood pressure associated with propofol in comparison with thiopentone. Propofol was associated with a quicker early recovery as well as a faster psychomotor recovery, as tested by a peg-board. However, complete psychomotor recovery was not achieved for up to three hours in some patients receiving propofol and so caution is advised regarding the early street fitness of patients receiving repeated doses of the drug for day case surgery.

scholarly journals Overnight in-hospital observation following tonsillectomy: retrospective study of post-operative intervention

2017 ◽  
Vol 132 (1) ◽  
pp. 46-52 ◽  
Author(s):  
S Morris ◽  
E Hassin ◽  
M Borschmann
Keyword(s):  
Patient Characteristics ◽  
University Hospital ◽  
Evidence Based ◽  
Airway Compromise ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
American Society ◽  
Evidence Based Guidelines ◽  
Critical Intervention

AbstractObjective:The safety of day-case tonsillectomy is widely documented in the literature; however, there are no evidence-based guidelines recommending patient characteristics that are incompatible with day-case tonsillectomy. This study aimed to identify which patients should be considered unsafe for day-case tonsillectomy based on the likelihood of needing critical intervention.Method:Retrospective review of 2863 tonsillectomy procedures performed at University Hospital Geelong from 1998 to 2014.Results:Of the patients, 7.81 per cent suffered a post-tonsillectomy complication and 4.15 per cent required intervention. The most serious complications, haemorrhage requiring a return to the operating theatre and airway compromise, occurred in 0.56 per cent and 0.11 per cent of patients respectively. The following patient characteristics were significantly associated with poorer outcomes: age of two years or less (p < 0.01), tonsillectomy indicated for neoplasm (p < 0.01) and quinsy (p < 0.05).Conclusion:The authors believe that all elective tonsillectomy patients should be considered for day-case surgery, with the following criteria necessitating overnight observation: age of two years or less; an indication for tonsillectomy of neoplasm or quinsy; and an American Society of Anesthesia score of more than 2.

scholarly journals COMPARISON BETWEEN MIDAZOLAM AND THIOPENTONE-BASED BALANCED ANAESTHESIA FOR DAY-CASE SURGERY

1984 ◽  
Vol 56 (2) ◽  
pp. 165-169 ◽  
Author(s):  
M.E. CRAWFORD ◽  
P. CARL ◽  
R.S. ANDERSEN ◽  
B.O. MIKKELSEN
Keyword(s):  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
Balanced Anaesthesia

Advances in general surgery 50 years ago

2021 ◽  
pp. 1-2
Author(s):  
Harold Ellis
Keyword(s):  
General Surgery ◽  
Varicose Veins ◽  
Peptic Ulcers ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
New Treatments

In 1971, some of the new advances that were set to change the field of general surgery included theories about the development of peptic ulcers, new treatments for varicose veins and pioneering work in the introduction of day case surgery.

Following up day case anaesthesia in general practice

1990 ◽  
Vol 28 (21) ◽  
pp. 81-82
Keyword(s):  
General Practice ◽  
Day Case ◽  
Day Case Surgery ◽  
Case Surgery ◽  
Case Anaesthesia ◽  
Discharge From Hospital

Many patients now have surgery as day cases, being admitted and discharged from hospital on the day of the operation; most have a general anaesthestic (GA). Serious complications are rare if day case surgery is confined to short, minor procedures in fit patients. However, both the patient and the GP need to be aware of the complications of anaesthesia which may arise after discharge from hospital. A future article will discuss other aspects of day case surgery.

Cancellation on the Day of Surgery in an Ambulatory Setting - A Retrospective Analysis

2021 ◽  
Author(s):  
João Manuel Teixeira Oliveira ◽  
Mariana Ginestal ◽  
Catarina Ferreira ◽  
Ana Povo ◽  
Eurico Castro Alves
Keyword(s):  
Inpatient Care ◽  
Ambulatory Surgery ◽  
Healthcare Management ◽  
Ambulatory Setting ◽  
Day Case ◽  
Chi Square ◽  
Day Case Surgery ◽  
Cancellation Rate ◽  
Case Surgery ◽  
Level Of Significance

Abstract Background: Cancellations on the day of surgery represent an important setback for patients and pose considerable drawbacks for healthcare management. Part of these cancellations are due to patients’ factors. Some studies have addressed this issue in inpatient care, but scarce information is found regarding ambulatory setting. This work intended to analyse the parameters that are important in patient cancellation on the day of surgery for ambulatory surgery, with a closer analysis on those that are patient dependent, specifying those that are significant in order to anticipate which patients will be cancelled beforehand.Methods: This work analysed a total of 19781 patients enrolled for elective day-case surgery in 2018, from which 1253 (6.33%) made a cancellation on their day of surgery. Results: Patients residing closer to the hospital (< 10 Km) had statistically more cancellations than those residing > 10 km away (p<0.05). Also, patients with 65 years of age or more had a higher cancellation rate (p<0.05). Finally, patients without a prior pre operative medical appointment might have a higher likelihood of same day cancellation (5.8% vs 14.01%, p<0.05). T-test and Chi-square tests were used with a level of significance of 0.05.Conclusions: We expect this work can contribute to anticipate the cancellation of a given patient, enabling quicker treatment with optimised resources.

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