Patient selection for day case surgery

Humphreys, Alexandra; Stocker, Mary

doi:10.1016/j.mpaic.2018.12.009

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…The majority of patients undergoing an operation at the isolated unit meet the Royal College of Surgeons guidelines eligibility for day surgery (Humphreys & Stocker 2019). All (100%) of the elective laparoscopic cholecystectomies in LLGH isolated unit and 71.4% at YG district general hospital were completed as day cases.…”

Section: Discussionmentioning

confidence: 99%

“…Following the application of a multiple binomial regression on patient variables in Table 3, the factors that retain significance are BMI, previous cholecystitis and previous ERCP (Table 4). Further grouping and regression of BMI into categories according to the current Royal College of Surgeons guidelines for day surgery (Humphreys & Stocker 2019), BMI <35kg/m 2 and BMI 35kg/m 2 do not retain significance (BMI <35kg/m 2 p ¼ 0.19; BMI 35kg/m 2 p ¼ 0.69).…”

Section: Patient Demographicsmentioning

confidence: 93%

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Day case laparoscopic cholecystectomy: Identifying patients for a ‘COVID-Cold’ isolated day-case unit during the pandemic

Hinchcliffe

Imran

Lala

2021

Journal of Perioperative Practice

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Background The UK practice of laparoscopic cholecystectomy has reduced during the COVID-19 pandemic due to cancellation of non-urgent operations. Isolated day-case units have been recommended as ‘COVID-cold’ operating sites to resume surgical procedures. This study aims to identify patients suitable for day case laparoscopic cholecystectomy (DCLC) at isolated units by investigating patient factors and unexpected admission. Method Retrospective analysis of 327 patients undergoing DCLC between January and December 2018 at Ysbyty Gwynedd (District General Hospital; YG) and Llandudno General Hospital (isolated unit; LLGH), North Wales, UK. Results The results showed that 100% of DCLCs in LLGH were successful; 71.4% of elective DCLCs were successful at YG. Increasing age ( p = 0.004), BMI ( p = 0.01), ASA Score ( p = 0.006), previous ERCP ( p = 0.05), imaging suggesting cholecystitis ( p = 0.003) and thick-walled gallbladder ( p = 0.04) were significantly associated with failed DCLC on univariate analysis. Factors retaining significance (OR, 95% CI) after multiple regression include BMI (1.82, 1.05–3.16; p = 0.034), imaging suggesting cholecystitis (4.42, 1.72–11.38; p = 0.002) and previous ERCP (5.25, 1.53–18.00; p = 0.008). Postoperative complications are comparable in BMI <35kg/m2 and 35–39.9kg/m2. Conclusions Current patient selection for isolated day unit is effective in ensuring safe discharge and could be further developed with greater consideration for patients with BMI 35–39.9kg/m2. As surgical services return, this helps identify patients suitable for laparoscopic cholecystectomy at isolated COVID-free day units.

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Section: Discussionmentioning

confidence: 99%

Section: Patient Demographicsmentioning

confidence: 93%

Day case laparoscopic cholecystectomy: Identifying patients for a ‘COVID-Cold’ isolated day-case unit during the pandemic

Hinchcliffe

Imran

Lala

2021

Journal of Perioperative Practice

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“…In their theoretical study, Humphreys and Stocker discuss the convenience of the surgical procedures and point to the possibility of the treating other groups of patients in a field of day surgery for the future [6]. The authors call attention to the social and medical criteria that are limited to the development of day surgery.…”

Section: Introductionmentioning

confidence: 99%

Quantification of Similarity Relationships According to Parameters of Day Surgery System

Gavurová

Kováč

Bejtkovský

2019

IJERPH

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Performing day surgery should minimise a number of hospitalisation cases, but its use is determined by many factors. It takes advantage of the latest advances in surgical care, enabling better use of highly costly specialised operating room equipment. This analysis of the day surgery system of the Slovak Republic stands on an examination of the five specialised fields-surgery, gynaecology, ophthalmology, otorhinolaryngology, and urology. The explored period covers the years 2009 to 2017. The whole analysis is divided into the two sections-the youth category and for the adult category. For each case, a hospitalisation ratio is computed. A map visualisation supports the analysis outcome. A quantification of the similarity relationships between the regions is done according to a Euclidean distance approach and it is illustrated through the heat map. The centremost region is the Žilina Region with distance at a level of 1.9821, meaning that it performs as the most similar region to a development of a hospitalisation ratio in the whole Slovak Republic regarding all the examined aspects. The findings introduce an important platform for a creation of regional and national health plans in the area of healthcare provision for the population of the country.Day surgery is one form of saving financial resources of health insurance companies, but its implementation is very expensive. In the recent years, the question of the economic efficiency of introduction of day surgery as well as the transformation of hospital departments into day surgery units has also come to the attention of research teams. This is also confirmed by the results of the study by Gabriel et al., who are concerned with an optimisation of the costs of day surgery performance and a process of finding opportunities for better organisation together with economic and personnel utilisation [3]. These authors also provide an interesting impetus for our subsequent research-an examination the risk factors and causalities associated with surgery and mortality.The conditions for performing day surgery are different for children than for adults, and they are set in a stricter regime. It also affects the type of diagnoses and comorbidities that are numerous for elderly patients. The same affect can be seen also among the youth population [4]. However, the benefits of day surgery in children outweigh the disadvantages for most children and families. Day surgery reduces the risk of nosocomial infections, the risk of anxiety, disturbed sleep, and so forth. For families, there is minimal disruption to working patterns and childcare needs. It also significantly reduces the economic burden on society. Every day surgery procedure not only provides considerable money savings, but also brings efficiency in medical practice in the healthcare system.Public policies should make greater efforts to achieve higher transparency and effective accountability, especially in public healthcare systems with a wide range of public and private healthcare service providers. According to many ...

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Recent developments and current controversies in short-stay endovascular aneurysm repair

Preece¹,

Stenson²,

Shaw³

et al. 2019

J Cardiovasc Surg

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Patient selection for day case surgery

Cited by 3 publications

References 4 publications

Day case laparoscopic cholecystectomy: Identifying patients for a ‘COVID-Cold’ isolated day-case unit during the pandemic

Day case laparoscopic cholecystectomy: Identifying patients for a ‘COVID-Cold’ isolated day-case unit during the pandemic

Quantification of Similarity Relationships According to Parameters of Day Surgery System

Recent developments and current controversies in short-stay endovascular aneurysm repair

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