caa a22 4500 606182721 CHVBK 20210128100817.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s00405-014-3071-x doi (NATIONALLICENCE)springer-10.1007/s00405-014-3071-x Day-case septoplasty: a default pathway or is case selection the key? [Elektronische Daten] [Ali Al-Hussaini, Hussein Walijee, Anwar Khan, Patrick Cuddihy] Septoplasty has been identified as suitable for day surgery, but is not commonly performed as such. Guidelines for day surgery stipulate that the unexpected re-admission rate should be 2-3%; however previous studies have not attained this target. The purpose of this study was to ascertain the surgical and patient factors associated with re-admission following day-case septoplasty. A retrospective case-notes analysis of day-case septoplasties between 1 January 2010 and 31 December 2012 was undertaken. Data on patient demographics, surgeon grade and operative technique were examined using a univariate analysis model. A total of 256 septoplasties were performed. 23 patients were admitted, overwhelmingly due to bleeding in the immediate post-operative period, giving an overall admission rate of 9.0% within the first 24h. Factors associated with re-admission included the use of intranasal splints (relative risk (RR) 5.34, p<0.001), the performance of additional operative procedures (RR 4.96, p<0.001) and surgery on patients with co-morbidities (RR 3.37, p=0.002). There was no correlation between unexpected admission and patient gender, age, surgeon grade, performance of revision surgery and operative factors including nasal preparation with cocaine, local anaesthetic infiltration, type of incision, number of mucoperichondrial flaps raised, extensive bony dissection, performance of a turbinate procedure, quilting, closure of incision and post-operative packing. Day-case septoplasty in patients with co-morbidities and where additional surgical procedures are performed may be associated with unexpected overnight admission. Thus, safe and efficient day-case septoplasty may not be suitable as a universal default pathway but one where case selection is key. Springer-Verlag Berlin Heidelberg, 2014 Septoplasty nationallicence Septal surgery nationallicence Day-case nationallicence Admission rate nationallicence Selection criteria nationallicence Al-Hussaini Ali Department of Otorhinolaryngology, Head and Neck Surgery, Royal Gwent Hospital, NP20 2UB, Newport, UK aut Walijee Hussein Department of Otorhinolaryngology, Head and Neck Surgery, Royal Gwent Hospital, NP20 2UB, Newport, UK aut Khan Anwar Department of Otorhinolaryngology, Head and Neck Surgery, Royal Gwent Hospital, NP20 2UB, Newport, UK aut Cuddihy Patrick Department of Otorhinolaryngology, Head and Neck Surgery, Royal Gwent Hospital, NP20 2UB, Newport, UK aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/1(2015-01-01), 91-95 0937-4477 272:1<91 2015 272 405 https://doi.org/10.1007/s00405-014-3071-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3071-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Al-Hussaini Ali Department of Otorhinolaryngology, Head and Neck Surgery, Royal Gwent Hospital, NP20 2UB, Newport, UK aut NATIONALLICENCE 700 1- Walijee Hussein Department of Otorhinolaryngology, Head and Neck Surgery, Royal Gwent Hospital, NP20 2UB, Newport, UK aut NATIONALLICENCE 700 1- Khan Anwar Department of Otorhinolaryngology, Head and Neck Surgery, Royal Gwent Hospital, NP20 2UB, Newport, UK aut NATIONALLICENCE 700 1- Cuddihy Patrick Department of Otorhinolaryngology, Head and Neck Surgery, Royal Gwent Hospital, NP20 2UB, Newport, UK aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/1(2015-01-01), 91-95 0937-4477 272:1<91 2015 272 405