{"title":"Evaluating ASC-4 Transfer Rates in Cataract Surgery: Insights into Timing and Causes of Hospital Transfers.","authors":"Nicholas R Stange, Matthew P Rauen","doi":"10.1097/j.jcrs.0000000000001613","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Setting: </strong>A large ophthalmology surgery center in Des Moines, Iowa.</p><p><strong>Design: </strong>Retrospective review.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cataract and refractive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/j.jcrs.0000000000001613","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
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.
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.