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PubMed · 17093366

Outcomes in day surgery.

Abstract

PURPOSE OF REVIEW: To summarize and examine the updated published results on the outcome measures that can be used to assess the quality of ambulatory surgery and anesthesia. RECENT FINDINGS: Major morbidity and mortality following ambulatory surgery is exceedingly low. Cancellations and delays may have a negative impact on the patients, healthcare personnel and the organizations. Minor cardiovascular adverse events are the most common intraoperatively and are associated with preexisting cardiovascular diseases and elderly patients. Respiratory events postoperatively are associated with obesity, smoking and asthma. Also, pain is a common cause for longer postoperative stay, unanticipated admission and readmission. Postoperative nausea and vomiting occurs in 30% of patients and strongly affects patient satisfaction. Furthermore, prolonged stays are mainly caused by surgical factors, or minor symptoms like pain or nausea. Surgical factors are also the main causes of unanticipated hospital admission. The type of surgery and the 24 h postoperative symptoms may affect the degree of return to daily living function. Also, patient satisfaction affects the outcome of healthcare and the use of healthcare services. SUMMARY: Ambulatory surgery, as currently practiced, provides quality care that is cost-effective. Minor adverse events such as pain and postoperative nausea and vomiting are still common, and improvement could be targeted in these areas.

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BibTeXRIS

Ilia Shnaider, Frances Chung. 2006. Outcomes in day surgery.. https://doi.org/10.1097/aco.0b013e328010107e

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The role of gait analysis in the orthopaedic management of ambulatory cerebral palsy.

PURPOSE OF REVIEW: The literature was reviewed to describe the role of gait analysis in the orthopaedic management of ambulatory children with cerebral palsy and examine the current best evidence to support these roles. RECENT FINDINGS: Gait laboratory analysis is superior to visual or observational analysis of gait because it provides an objective record of gait that is able to quantify the magnitude of deviations of pathologic gait from normal and also explain these abnormalities. Recognizable gait patterns can be classified and used for making treatment decisions, the effectiveness of which can be assessed using gait analysis as a measure of gait outcomes. There are many sources of variability, however, including patients themselves, the gait laboratories and testing processes, interpretation of data and surgeons' surgical recommendations. SUMMARY: Although gait analysis has been shown to alter decision making, there is little evidence that the decisions based on gait analysis lead to better outcomes. Consequently, clinical gait analysis remains controversial, with wide variation in the rates of utilization of gait analysis in the management of children with ambulatory cerebral palsy. The time is ripe for clinical trials and cohort studies to provide the evidence to establish the appropriate utilization of this technology.

Ambulatory Surgical Procedures↗