Catastrophic outcomes are rare in outpatient plastic surgery: a multicenter analysis of 10,954 patients
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Catastrophic outcomes of outpatient plastic surgery such as septic shock, myocardial infarction, and death are rare. Few studies have provided robust data on risk factors associated with these events. This study utilizes an independent, multicenter database to investigate the incidence and predictive factors of catastrophic outcomes associated with outpatient plastic surgery.
Patients in the National Surgical Quality Improvement Program (NSQIP) participant use database who underwent outpatient plastic surgery between 2006 and 2010 were identified. Demographic information for patients and rates of catastrophic outcomes within 30 days of surgery (sepsis/septic shock, pulmonary embolism, stroke, myocardial infarction (MI), cardiac arrest, coma, and death) was determined.
Over the 5-year study period, 10,954 patients underwent an outpatient plastic surgery procedure. Thirty-one patients presented with catastrophic outcomes (0.28 %). These patients had a total of 34 catastrophic outcomes: 20 sepsis/septic shock (58.8 %), 5 pulmonary embolism (14.7 %), 3 stroke (8.8 %), 2 cardiac arrest (5.9 %), and 4 death (11.7 %). No occurrences of MI or coma were reported.
Outpatient plastic surgery can be performed safely in accredited ambulatory facilities as demonstrated by the overall 0.28 % catastrophic outcome rate garnered from a 5-year review of the NSQIP database.
Level of Evidence: Level III, prognostic/risk study.
- Dhumale R, Tisdale J, Barwell N (2010) Over a thousand ambulatory hernia repairs in a primary care setting. Ann R Coll Surg Engl 92:127–130 CrossRef
- Ford SJ, Wheeler JM, Borley NR (2010) Factors influencing selection for a day-case or 23-h stay procedure in transanal endoscopic microsurgery. Br J Surg 97:410–414 CrossRef
- Keyes GR, Singer R, Iverson RE et al (2008) Mortality in outpatient surgery. Plast Reconstr Surg 122:245–250, discussion 251–253 CrossRef
- Keyes GR, Singer R, Iverson RE et al (2004) Analysis of outpatient surgery center safety using an internet-based quality improvement and peer review program. Plast Reconstr Surg 113:1760–1770 CrossRef
- Liu JT, Briner RP, Friedman JA (2009) Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series. BMC Surg 9:3 CrossRef
- Russo A, Elixhauser A, Steiner C et al (2007) Hospital-based ambulatory surgery, 2007: Statistical Brief #86. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Agency for Health Care Policy and Research; 2006-2010
- Iverson RE, Lynch DJ (2002) Patient safety in office-based surgery facilities: II. Patient selection. Plast Reconstr Surg 110(7):1785–1790, discussion 1791-2 CrossRef
- Short KK, Ringler SL, Bengtson BP et al (1996) Reduction mammoplasty: a safe and effective outpatient procedure. Aesthetic Plast Surg 20:513–518 CrossRef
- Dasid J, Detmer DE (1972) The ambulatory surgical unit. Ann Surg 175:856 CrossRef
- Davies BW, Lewis RD, Pennington GA (1996) Reduction mammoplasty: a comparison of outpatient and inpatient procedures. Aesthetic Plast Surg 20:77–80 CrossRef
- Detmer DE, Gelijns AC (1994) Ambulatory surgery: a more cost-effective treatment strategy? Arch Surg 129:123–127 CrossRef
- ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2011 (2012) International Society of Aesthetic Plastic Surgery. http://www.isaps.org/files/html-contents/Downloads/ISAPS%20Results%20-%20Procedures%20in%202011.pdf. Accessed 1 January 2013
- 2011 Plastic Surgery Statistics Report (2012) American Society of Plastic Surgeons. http://www.plasticsurgery.org/Documents/news-resources/statistics/2011-statistics/2011_Stats_Full_Report.pdf. Accessed 1 January 2013
- Engbaek J, Bartholdy J, Hjortso NC (2006) Return hospital visits and morbidity within 60 days after day surgery: a retrospective study of 18,736 day surgical procedures. Acta Anaesthesiol Scand 50:911–919 CrossRef
- Natof HE (1980) Complications associated with ambulatory surgery. JAMA 244:1116–1118 CrossRef
- Mezei G, Chung F (1999) Return hospital visits and hospital readmissions after ambulatory surgery. Ann Surg 230:721–727 CrossRef
- Stevens WG, Gear AJ, Stoker DA et al (2008) Outpatient reduction mammoplasty: an eleven-year experience. Aesthet Surg J 28(2):171–179 CrossRef
- Stevens WG, Repta R, Pacella SJ et al (2009) Safe and consistent outcomes of successfully combining breast surgery and abdominoplasty: an update. Aesthet Surg J 29(2):129–134 CrossRef
- Buenaventura S, Severinac R, Mullis W et al (1996) Outpatient reduction mammoplasty: a review of 338 consecutive cases. Ann Plast Surg 36:162–166 CrossRef
- Scott GR, Carson CL, Borah GL (2005) Maximizing outcomes in breast reduction surgery: a review of 518 consecutive patients. Plast Reconstr Surg 116:1633–1639, discussion 1640-1641 CrossRef
- User guide for the 2010 Participant use Data File (2011) American College of Surgeons National Surgical Quality Improvement Program Web site. http://site.acsnsqip.org/wp-content/uploads/2012/03/2010-User-Guide_FINAL.pdf. Accessed 1 December 2012
- Birkmeyer JD, Shahian DM, Dimick JB et al (2008) Blueprint for a new American College of Surgeons: national surgical quality improvement program. J Am Coll Surg 207:777–782 CrossRef
- Rowell KS, Turrentine FE, Hutter MM et al (2007) Use of national surgical quality improvement program data as a catalyst for quality improvement. J Am Coll Surg 204:1293–1300 CrossRef
- Ogunleye AA, de Blacam C, Curtis MS et al (2012) An analysis of delayed breast reconstruction outcomes as recorded in the American College of Surgeons National Surgical Quality Improvement Program. J Plast Reconstr Aesthet Surg 65(3):289–294 CrossRef
- Pannucci CJ, Shanks A, Moote MJ et al (2012) Identifying patients at high risk for venous thromboembolism requiring treatment after outpatient surgery. Ann Surg 225(6):1093–1099 CrossRef
- Shabbir J, Ridgway PF, Shields W et al (2006) Low molecular weight heparin prophylaxis in day case surgery. Ir J Med Sci 175:26–29 CrossRef
- Leonard F, Lecuru F, Rizk E et al (2000) Perioperative morbidity of gynecological laparoscopy. Acta Obstet Gynecol Scand 79:129–134 CrossRef
- Cook JL, Perone JB (2003) A prospective evaluation of the incidence of complications associated with Mohs micrographic surgery. Arch Dermatol 139(2):143–152 CrossRef
- Berger RA, Walsh SM (2009) Outpatient total knee arthroplasty: pathways and protocols. Tech Knee Surg 8(2):115–118 CrossRef
- Haynes AB, Weiser TG, Berry WR et al (2009) A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 360:491–499 CrossRef
- Catastrophic outcomes are rare in outpatient plastic surgery: a multicenter analysis of 10,954 patients
European Journal of Plastic Surgery
Volume 36, Issue 9 , pp 573-578
- Cover Date
- Print ISSN
- Online ISSN
- Springer Berlin Heidelberg
- Additional Links
- Industry Sectors