Substantial proportion of revisits post ambulatory Sx occur in ER

(HealthDay)—Acute care revisits occur with considerable frequency among low-risk patients undergoing ambulatory operations, with a substantial proportion of revisits occurring in emergency departments, according to a research letter published in the Oct. 6 issue of the Journal of the American Medical Association.

Claudia A. Steiner, M.D., M.P.H., from the Agency for Healthcare Research and Quality in Rockville, Md., and colleagues examined the rates of all-cause unplanned revisits within 30 days of ambulatory surgery and whether these revisits were related to surgery. Data were included from six low- to moderate-risk ambulatory procedures.

The researchers identified 482,034 ambulatory operations and 45,760 all-cause 30-day revisits (94.9 per 1,000 operations). Most revisits were to the emergency department, followed by inpatient and surgery settings (58.7, 27.0, and 9.2 per 1,000, respectively). Two-thirds of revisits were for complications related to the index surgery (65.2 per 1,000), while up to one-third of revisits were for unrelated conditions (29.7 per 1,000). Most inpatient and emergency department revisits were for complications related to the index surgery; this pattern was seen for all six types of operation.

"Considering the burden of revisits to patients and hospitals following ambulatory operations, our study highlights the importance of expanding health policy and clinical interventions to include ambulatory surgery and complications assessed in the emergency department," the authors write.

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