Étude de faisabilité pour la mise en place d’une filière de chirurgie ambulatoire en urgence

Introduction

Development of outpatient care is one of the major goals of public health policy in our country. For the purpose of this study, we set up an emergency outpatient surgery unit 24 hours a day in our hospital. We assessed the feasibility of such a unit with a length of stay less than 12 hours and no patient readmission.

Patients and methods

A prospective observational and monocentric study was conducted in our hospital by systematically including patients eligible for emergency surgery outpatient care. We built a database compiling patient characteristics, lengths of stay, surgical and anesthesic procedures, complications and readmission rate. Satisfaction was then assessed by the « EVAN-G » questionnaire.

Results

From May 2011 to October 2012, 147 patients were included in our research. They were 31 years old [25–43]. Hundred and twenty-six of them (86%) remained in the outpatient procedure without any readmission. Twenty-one (14%) were excluded, essentially for surgical contraindications or due to the absence of an accompanying person. Length of stay was of 10.5 hours [8.5–13]. The satisfaction survey showed an average score of 83/100.

Conclusion

The setting up of an ambulatory emergency surgery unit is possible after proper training of emergency care specialists, anesthesiologists, and surgeons. This activity is compatible with safe care and a high level of patient satisfaction. It must be considered as part of the emergency procedures available and should not be systematically ruled out.