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Study: Few complications in outpatient hand, shoulder surgeries

During an 11-year period, a surgical center in Pennsylvania had a 0.2 percent complication rate.

By Stephen Feller

WASHINGTON, April 21 (UPI) -- Outpatient care has increased in recent years as a method of reducing healthcare costs, and researchers report at least one area where this practice appears to also be very safe.

A large study of patients at an outpatient center in Pennsylvania showed 0.2 percent of patients during 11 years had adverse health events after hand or shoulder procedures, researchers at Ohio State University report in a study published in the Journal of Bone and Joint Surgery.

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While researchers say studies have the efficiency and cost savings possible with outpatient services, a "paucity" of research on safety has been conducted, Dr. Kanu Goyal, an orthopedic surgeon at Wexner Medical Center, said in a press release.

Generally, healthier patients with fewer potential complications are treated at outpatient facilities, however this does not necessarily make the procedures any more safe.

For the study, researchers analyzed the records of 28,737 hand and upper extremity procedures performed at an outpatient surgical center in Pennsylvania between 2001 and 2012, defining serious complications as those causing harm or requiring additional treatment.

Potential complications were divided into seven categories -- infection requiring antibiotics or return to operating room; transfer to hospital; wrong-site surgical procedure; retention of a foreign object; postoperative symptomatic thromboembolism; medication error; and bleeding complications -- and were then analyzed for outcome ranging from additional testing, treatment or disability of some sort.

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During the 11-year period, the clinic reported a total of 58 adverse events, for an overall risk rate of 0.20 percent. Among the events, there were 14 infections, 18 transfers to the hospital, 21 later hospital admissions, one medication error, four postoperative hemotomas and no deaths.

"Our study shows that with proper patient selection, hand and upper extremity surgery can be completed safely at a free-standing ambulatory surgery center," Goyal said.

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