Evaluating ASC-4 Transfer Rates in Cataract Surgery: Insights into Timing and Causes of Hospital Transfers.

IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Journal of cataract and refractive surgery Pub Date : 2025-01-21 DOI:10.1097/j.jcrs.0000000000001613
Nicholas R Stange, Matthew P Rauen
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Abstract

Purpose: To describe the causes, timing, and contributing factors of direct hospital transfer cases from an ophthalmology-specific ambulatory surgery center and to identify potential strategies for decreasing future transfers.

Setting: A large ophthalmology surgery center in Des Moines, Iowa.

Design: Retrospective review.

Methods: A retrospective chart review was performed on patients requiring hospital transfer from a Midwest ophthalmology-specific surgery center from March 2022 through July 2024. Variables reviewed included patient demographics, comorbidities, prior surgeries/surgical complications, results of pre-operative physical exams, type of surgery and anesthesia performed, the type and timing of each complication, and the reasons for transfer. Each transfer was assessed for its necessity, preventability, and outcome.

Results: A total of 22 patients required hospital transfer out of 24,960 admissions for a rate of 0.88 per 1,000 admissions (95% CI: 0.58-1.33). Only 5 (23%) transfer cases were temporally related to anesthesia or surgery. The other 17 (77%) had concerns first noted prior to the induction of anesthesia. Nine (41%) of the surgeries were completed, 1 (5%) partially completed, and the remaining 12 (55%) surgeries were cancelled. The reasons for transfer were largely cardiac and/or blood pressure related (18/22, 82%). Nearly a third of the transfers (7/22, 32%) were considered preventable.

Conclusion: Hospital transfers from ASCs are rare and all-cause hospital transfer rates may overestimate the true risk of ocular surgery. Most patients requiring hospital transfer were identified in the pre-operative area. Greater attention to preoperative physical exam reports could potentially prevent some hospital transfers.

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评估白内障手术中ASC-4转移率:医院转移的时机和原因
目的:描述从眼科门诊中心直接转院病例的原因、时间和影响因素,并确定减少未来转院的潜在策略。地点:爱荷华州得梅因的一家大型眼科手术中心。设计:回顾性审查。方法:回顾性分析2022年3月至2024年7月从中西部眼科专科手术中心转院的患者。评估的变量包括患者人口统计学、合并症、既往手术/手术并发症、术前体检结果、手术类型和麻醉、每种并发症的类型和时间以及转移的原因。对每次转移的必要性、可预防性和结果进行评估。结果:在24,960名住院患者中,共有22名患者需要转院,转院率为0.88 / 1,000 (95% CI: 0.58-1.33)。只有5例(23%)转移病例暂时与麻醉或手术有关。另外17例(77%)在麻醉诱导前就有顾虑。完成9例(41%),部分完成1例(5%),取消12例(55%)。转移的原因主要是心脏和/或血压相关(18/22,82%)。近三分之一的转移(7/ 22,32%)被认为是可以预防的。结论:ASCs的转院率很少见,全因转院率可能高估了眼科手术的真实风险。大多数需要转院的患者是在术前确定的。对术前体检报告的更多关注可能会避免一些医院转院。
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来源期刊
CiteScore
5.60
自引率
14.30%
发文量
259
审稿时长
8.5 weeks
期刊介绍: The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS). JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.
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