Ambulatory Surgical Centers: A Review of Complications and Adverse Events

J Am Acad Orthop Surg. 2017 Jan;25(1):12-22. doi: 10.5435/JAAOS-D-15-00632.

Abstract

An increasing number of orthopaedic surgeries are performed at ambulatory surgical centers (ASCs), as is exemplified by the 272% population-adjusted increase in outpatient rotator cuff repairs from 1996 to 2006. Outpatient surgery is convenient for patients and cost effective for the healthcare system. The rate of complications and adverse events following orthopaedic surgeries at ASCs ranges from 0.05% to 20%. The most common complications are pain and nausea, followed by infection, impaired healing, and bleeding; these are affected by surgical and patient risk factors. The most important surgeon-controlled factors are surgical time, type of anesthesia, and site of surgery, whereas the key patient comorbidities are advanced age, female sex, diabetes mellitus, smoking status, and high body mass index. As the use of ASCs continues to rise, an understanding of risk factors and outcomes becomes increasingly important to guide indications for and management of orthopaedic surgery in the outpatient setting.

Publication types

  • Review

MeSH terms

  • Ambulatory Surgical Procedures / adverse effects
  • Ambulatory Surgical Procedures / statistics & numerical data*
  • Humans
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Risk Factors
  • Surgicenters / methods
  • Surgicenters / statistics & numerical data*