Psychosocial characteristics and complications in outpatients in a French University Hospital

Background The objectives were to describe outpatients’ psychosocial characteristics and to identify the prevalences of unanticipated hospital admission immediately following outpatient surgery and of severe complications in outpatients at one month after ambulatory surgery. Methods A prospective cohort study was conducted during one month in Rouen University Hospital in January 2017. An anonymous questionnaire was administered in outpatients before hospital discharge. After another month after discharge, data regarding unanticipated hospital admission (primary endpoint) and readmission for complication related to ambulatory surgery and risk factors of readmission depending on psychosocial level (secondary endpoint) were collected from patient medical records. Data included demographic and psychosocial characteristics information on surgery and anesthesia. Results A total of 598 outpatients were included during a month, which represented 85.7% of the outpatients of the hospital unit. The mean age was 50.8 years old (SD = 19.8), the sex ratio male/female was 0.68. Among the outpatients, 93.8% had an ASA Physical Status of I or II. There were 23.5% ophthalmic surgeries, 19.0% gynecological surgeries, 17.7% orthopedic surgeries, 8.3% plastic surgeries; 47.5% of operations were carried out under general anesthesia and 16.6% under regional anesthesia. Twenty percent of outpatients lived alone and 2.6% lived alone and socially isolated; 1.6% of outpatients returned home as a pedestrian and 3.4% used public transportation; 13.7% of outpatients were not accompanied for the first night after surgery. There were 11 (1.84%) unanticipated hospital admissions (7 for medical reasons, 1 for surgery and 3 for organizational difficulty). There were 11 (1.84%) patients that returned in hospital in the 30 days that followed the surgery with 3 readmissions. There was no difference between patients with low socioeconomic status and other patients for unanticipated hospital admission or readmission (working outpatients versus not working, P = 0.42, outpatients with primary, middle or secondary education versus higher education, P = 1.00). Conclusions In our study, the prevalence of unanticipated hospital admission and readmission was low and comparable to the literature. In this work, the psychosocial level was not a risk factor of unanticipated hospital admission or readmission after ambulatory surgery.