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Are Ambulatory Surgical Patients as Healthy as We Think?

HSS Journal

Introduction: Over the last 30 years there has been a strong trend towards the performance of surgery in the ambulatory, outpatient setting.  In 1982, of all operations performed in the US, 20% were performed as outpatient procedures; by 1995 this figure had risen to 60%.[1] This trend has been particularly evident in the field of Orthopedic Surgery.  For example, at Hospital for Special Surgery, which focuses exclusively on musculoskeletal disease, there were over 7,000 Ambulatory Surgeries (AMS) performed in 2004.  This is in contrast to approximately 4,700 outpatient procedures performed in 1996.

Although economically advantageous, AMS challenges the system of care in a variety of ways, perhaps most significantly in the arena of preoperative medical evaluation. Medical consultations on these patients are usually ordered at the discretion of the attending surgeon. In general, patients undergoing AMS are younger and healthier than those being admitted for inpatient procedures. However, given that an increasing proportion of surgery is being performed on an AMS basis, it is likely that older and potentially less healthy patients are being offered this option. Therefore, this study was undertaken to determine if a simple self-reported health status questionnaire could be an effective tool to capture medical comorbidities that might impact perioperative care.

This article appears in HSS Journal: Volume 2, Number 2.
View the full article at springerlink.com.

About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


Headshot of Steven K. Magid, MD
Steven K. Magid, MD
Attending Physician, Hospital for Special Surgery
Professor of Clinical Medicine, Weill Cornell Medical College
Headshot of Lisa A. Mandl, MD, MPH
Lisa A. Mandl, MD, MPH
Assistant Attending Physician, Hospital for Special Surgery
Assistant Research Professor of Medicine, Weill Cornell Medical College
Headshot of C. Ronald MacKenzie, MD
C. Ronald MacKenzie, MD
Attending Physician, Hospital for Special Surgery
Co-Medical Director, Center for Brachial Plexus and Traumatic Nerve Injury

Cookie Reyes
Department of Medicine
Hospital for Special Surgery

Marc Lachs, BS
Department of Medicine
Hospital for Special Surgery


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