Outcome after day-care surgery in a major teaching hospital

Outcome has been measured for 6000 consecutive procedures in a major public teaching hospital day surgery unit. The unanticipated hospital admission rate was 1.34% and surgery-related admissions (0.95%) exceeded those related to anaesthesia (0.13%). Perioperative complications related to surgery (1:105) were more frequent than those related to anaesthesia (1:176) and pre-existing medical problems (1:500). Anaesthesia-related complications were more frequent with general anaesthesia (1:114) than with local anaesthesia plus sedation (1:780) or regional anaesthesia (1:180). Recovery times after general anaesthesia were longer than after other anaesthetic techniques but did not correlate with patient age (r = 0.04; P = 0.02) and only weakly correlated with procedure duration (r = 0.21; P < 0.01). At early follow-up, 4.0% of patients had presented to a local medical practitioner and 3.1% to a hospital accident and emergency service, usually for minor problems. Take home analgesia was adequate for 95% of patients and 98.9% were happy with the day surgery service. Day surgery in a teaching hospital can provide satisfactory outcome, with low complication rates, high patient acceptance and low community support requirements after patient discharge.