Steven Young1, Fred E Shapiro1,2, Richard D Urman2,3. 1. Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School. 2. Institute for Safety in Office-Based Surgery. 3. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the current knowledge about patient safety and outcomes in the office-based setting. Ambulatory procedures performed outside the hospital are steadily increasing, resulting in an increasing number and complexity of office-based procedures and patient comorbidities over the past two decades. In this review we focus on most recent outcomes studies encompassing different surgical specialties and patient populations. RECENT FINDINGS: Rates of complications in the office-based surgical (OBS) setting from the latest publications are similar to, or lower than previously reported studies. Many of the studies published were in the field of plastic surgery, with a few publications on office vascular and dental procedures. The most common complications were haematoma, infection and venous thromboembolism (VTE) and pulmonary embolism. Death was a rare finding, though when it occurred, it was often associated with VTE/pulmonary emboli and abdominoplasties. SUMMARY: Overall, these studies contribute positively to our current understanding of the safety of office-based anaesthesia. As an increasing number of procedures migrate from the hospital setting to ambulatory and office-based environments, it will be critically important to ensure high quality and safe patient care in these settings.
PURPOSE OF REVIEW: The purpose of this review is to provide an update on the current knowledge about patient safety and outcomes in the office-based setting. Ambulatory procedures performed outside the hospital are steadily increasing, resulting in an increasing number and complexity of office-based procedures and patient comorbidities over the past two decades. In this review we focus on most recent outcomes studies encompassing different surgical specialties and patient populations. RECENT FINDINGS: Rates of complications in the office-based surgical (OBS) setting from the latest publications are similar to, or lower than previously reported studies. Many of the studies published were in the field of plastic surgery, with a few publications on office vascular and dental procedures. The most common complications were haematoma, infection and venous thromboembolism (VTE) and pulmonary embolism. Death was a rare finding, though when it occurred, it was often associated with VTE/pulmonary emboli and abdominoplasties. SUMMARY: Overall, these studies contribute positively to our current understanding of the safety of office-based anaesthesia. As an increasing number of procedures migrate from the hospital setting to ambulatory and office-based environments, it will be critically important to ensure high quality and safe patient care in these settings.