The high-risk patient for ambulatory surgery

Area of Science:

• Anesthesiology
• Perioperative Medicine
• Ambulatory Surgery

Background:

• Increasingly complex ambulatory procedures are performed on aging populations with comorbidities.
• Patients expect rapid recovery and same-day discharge, necessitating careful pre-operative assessment.
• The rise in obesity and longevity contributes to a sicker patient population undergoing outpatient surgery.

Purpose of the Study:

• To outline processes for identifying high-risk patients during ambulatory procedure scheduling.
• To enable multidisciplinary prehabilitation and optimization pathways for risk mitigation.
• To provide guidance for anesthesiologists in managing high-risk patients in the ambulatory setting.

Main Methods:

• Review of current literature on patient identification and optimization for ambulatory surgery.
• Focus on general principles and best practices for managing patients with comorbidities.
• Description of anesthetic management strategies for specific high-risk conditions.

Main Results:

• High-risk patients undergoing ambulatory surgery often have multiple comorbidities.
• Patient preparation, value-based care, and perioperative physician roles are critical.
• Multidisciplinary collaboration is key to successful prehabilitation and optimization.

Conclusions:

• Proactive identification and management of high-risk patients improve outcomes in ambulatory surgery.
• Anesthesiologists play a vital role as perioperative physicians in optimizing patients.
• Establishing best practices ensures safer and more effective ambulatory surgical care.