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Safety and Readmission in Pediatric Ambulatory Surgery in a Tertiary Hospital
Assem M Alghamdi1, Saud A Aljadaan1,2, Saif A Alsemairi1
1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Insights
Pediatric ambulatory surgery demonstrates a 0% mortality rate with low complication and readmission rates. Longer surgical duration is linked to increased complication risk in children undergoing outpatient procedures.
Area of Science:
- Pediatric Surgery
- Ambulatory Care
- Surgical Outcomes
Background:
- Ambulatory surgery is increasingly utilized for pediatric patients.
- Assessing safety and outcomes is crucial for optimizing pediatric surgical care.
- Understanding risk factors for complications and readmissions is essential.
Purpose of the Study:
- To evaluate the safety and outcomes of pediatric ambulatory surgery.
- To determine complication and readmission rates.
- To identify risk factors associated with adverse events in pediatric ambulatory surgery.
Main Methods:
- A cross-sectional study analyzed 462 pediatric ambulatory surgery cases from June 2015 to May 2018.
- Data collected included patient demographics, American Society of Anesthesiologists (ASA) classification, complications, and readmissions.
- Statistical analyses included Chi-square, T-test, ANOVA, and logistic regression to identify risk factors.
Main Results:
- The study found a 0% mortality rate in pediatric ambulatory surgery.
- Readmission rates were approximately 3.5%, and complication rates were 10.6%.
- Only the duration of surgery showed a significant association with complications (p = 0.035).
Conclusions:
- Pediatric ambulatory surgery is associated with zero mortality.
- Complication and readmission rates are low, indicating a safe practice.
- Increased surgical duration is a risk factor for complications in pediatric ambulatory surgery.
Objectives:
To assess the safety and outcome of pediatric ambulatory surgery by measuring the rate of complications and readmission and identifying common risk factors for complications and readmission.
Materials And Methods:
A cross-sectional study was conducted at King Abdullah Specialist Children's Hospital (KASCH), Riyadh, Kingdom of Saudi Arabia, using the BESTCare 2.0 Health Information System (SKHIC, Riyadh, Saudi Arabia). All cases admitted under the pediatric ambulatory surgery unit from June 2015 to May 2018 were included. We reviewed 462 medical charts and recorded the variables of age, sex, American Society of Anesthesiologists (ASA) classification, complications, and readmission within one month of the surgery. SPSS (IBM Corp., Armonk, NY, USA) was used for data analysis. Associations between exposure variables (e.g., age, duration of surgery) and the outcome variables (e.g., rate of readmission and complications) were measured using the Chi-square test for categorical variables, the T-test and analysis of variance (ANOVA) for numerical and categorical variables, and logistic regression for multiple variables to control confounding variables.
Results:
Approximately, 3.5% of the pediatric ambulatory surgery cases required readmission, and 10.6% of the patients had complications with zero mortality. All the variables had no significant association either with the readmission or complications (p > 0.05), except for the duration of surgery in minutes which was associated with complications (OR 1.006, 95% CI, 1.000-1.012, P = 0.035).
Conclusion:
Among pediatric ambulatory surgery cases, the mortality rate is 0%, with low complications and readmission rates. Also, the longer the surgery, the higher the risk of complications.
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