Ambulatory surgery associated with low rates of postsurgical visits for infections

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1. 3.09 per 1000 ambulatory surgical procedures required postsurgical acute care visits for clinically significant infections at 14 days and 4.84 per 1000 at 30 days.

Evidence Rating Level: 2 (Good)   

Study Rundown: Ambulatory surgery accounts for a growing proportion of surgical procedures. While concern has previously been voiced regarding the quality of infection control practices in such settings, there is minimal data regarding the risk of infection following outpatient procedures. This study confirmed a low rate of postsurgical acute care visits for clinically significant infections following ambulatory procedures. Nonetheless, it must be noted that the despite a low rate, there is still a significant absolute number of complications due to the sheer number of ambulatory procedures that occur daily. As most postsurgical acute care visits occur within 2 weeks of the procedure and likely prior to the routine follow-up visit, earlier follow up communication with patients may allow clinicians to identify and manage post-surgical complications at an earlier time point.

While this study utilized data from several different states, it may not be representative of the national population as a whole. Nonetheless, in spite of its retrospective design, the study provides valuable information regarding the rates of postsurgical infections for ambulatory surgery procedures.

Click to read the study in JAMA

Relevant Reading: Surgical site infections: how high are the costs?

In-Depth [retrospective study]: This retrospective study utilized encounter data from 8 states in the 2010 Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project (HCUP) State Ambulatory Surgery Database and State Inpatient Databases. ICD-9-CM and CPT diagnosis and procedure codes were used to analyze 284,098 ambulatory surgical procedures for postsurgical encounters involving a clinically significant surgical site infection. Postsurgical encounters included hospitalizations and ambulatory surgical visits but did not include post-surgical encounters in physician offices or emergency department visits resulting in discharge. 3.09 per 1000 ambulatory surgical procedures involved post surgical acute care visits for clinically significant surgical site infections at 14 days (95%CI, 2.89-3.30) and 4.84 per 1000 ambulatory surgical procedures at 30 days (95% CI, 4.59-5.10).

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