Emergency Department Utilization After Outpatient Hand Surgery

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Patient Outcomes

Background:

• Elective outpatient hand surgery is common.
• Understanding emergency department (ED) utilization post-surgery is crucial for optimizing patient care.
• Identifying risk factors for ED visits can improve resource allocation and patient safety.

Purpose of the Study:

• To determine the rate of emergency department (ED) visits following elective outpatient hand surgery.
• To identify the most frequent reasons for these ED presentations.
• To ascertain preoperative risk factors associated with ED utilization.

Main Methods:

• Retrospective cohort study analyzing data from 2014-2015.
• Utilized New York and Florida State Databases for patient identification.
• Performed bivariate and multivariate analyses to identify predictors of ED visits.

Main Results:

• Overall 7-day and 30-day ED visit rates were 1.8% and 4.4%, respectively.
• Postoperative pain was the leading cause for ED visits (25.4% at 7 days, 16.1% at 30 days).
• Comorbidities (CHF, lung disease, diabetes, renal failure) and insurance type (Medicare, Medicaid) were significant risk factors for ED visits.

Conclusions:

• Emergency department utilization after elective hand surgery is low.
• Postoperative pain is the primary driver of ED visits, with most patients not requiring admission.
• Preoperative risk factors and insurance status influence the likelihood of an ED visit.