[Analysis of outpatients readmitted to an ambulatory surgery program]

To quantify readmission rates due to both major and minor complications per year of study in an ambulatory surgery program and to assess the effect of including patients with greater severity on the results.

We performed a retrospective study of patients undergoing surgery in an ambulatory surgery program in our health center between 1998 and 2003. During the study period, 25,553 patients met the selection criteria for elective ambulatory surgery. To analyze the evolution of complications over the study period, the first year of the study period was taken as the reference, and the chi(2) test was used to measure tendency, obtaining annual odd ratios (OR) and their respective confidence intervals.

The substitution index in the study period was 55.25%. The proportional risk of a major complication in our series was 1:426. The number of patients readmitted from home represented 0.83% of the total number of patients undergoing ambulatory surgery. The most common causes of readmission were surgically-related occurrences, mainly bleeding from the surgical site. Most complications were minor, the most frequently found problem being pain in the surgical wound.

Safety is an attitude and when the surgeon and the anesthesiologist apply appropriate patient selection criteria and perform a careful preanesthesia evaluation, there is no reason to expect more complications in ambulatory patients than in inpatients.