Short Stay Carotid Surgery for Veterans: An Emerging Standard

We have taken the short stay approach to carotid artery surgery to our VA setting over the past 5 to 6 years. Retrospectively, we reviewed the efficacy and safety of that approach in 201 consecutive carotid operations over the recent 4-year period (January 1, 1996–December 31, 1999). In 1996 we had...

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Veröffentlicht in:The Journal of surgical research 2001-01, Vol.95 (1), p.32-36
Hauptverfasser: Littooy, F.N., Steffen, G., Greisler, H.P., Kang, S.S., Mansour, M.A., Chmura, C.
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container_end_page 36
container_issue 1
container_start_page 32
container_title The Journal of surgical research
container_volume 95
creator Littooy, F.N.
Steffen, G.
Greisler, H.P.
Kang, S.S.
Mansour, M.A.
Chmura, C.
description We have taken the short stay approach to carotid artery surgery to our VA setting over the past 5 to 6 years. Retrospectively, we reviewed the efficacy and safety of that approach in 201 consecutive carotid operations over the recent 4-year period (January 1, 1996–December 31, 1999). In 1996 we had already begun the transition to an algorithm to (1) utilize carotid color flow Doppler duplex exams for diagnosis, (2) same-day admission (SDA), (3) intensive care unit (ICU) only when deemed medically necessary, and (4) next-day discharge. Results of this approach have been a decrease in the utilization of diagnostic arteriograms and utilization of the ICU from 100% previous to the onset of this approach to 17 and 22%, respectively. SDA increased from 24 to 89%. Mean LOS decreased from 5.13 ± 0.9 to 1.97 ± 0.4 days. The percentage of patients completing the algorithm went from 15 to 72%. Stroke and/or death varied from 0 to 3.7% each year and was only 2.4% over the 4-year period. In conclusion, this approach to short stay carotid surgery in the veteran population has proven both efficacious and safe with results similar to those in university and community practices.
doi_str_mv 10.1006/jsre.2000.6034
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Retrospectively, we reviewed the efficacy and safety of that approach in 201 consecutive carotid operations over the recent 4-year period (January 1, 1996–December 31, 1999). In 1996 we had already begun the transition to an algorithm to (1) utilize carotid color flow Doppler duplex exams for diagnosis, (2) same-day admission (SDA), (3) intensive care unit (ICU) only when deemed medically necessary, and (4) next-day discharge. Results of this approach have been a decrease in the utilization of diagnostic arteriograms and utilization of the ICU from 100% previous to the onset of this approach to 17 and 22%, respectively. SDA increased from 24 to 89%. Mean LOS decreased from 5.13 ± 0.9 to 1.97 ± 0.4 days. The percentage of patients completing the algorithm went from 15 to 72%. Stroke and/or death varied from 0 to 3.7% each year and was only 2.4% over the 4-year period. 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source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Aged
Biological and medical sciences
Carotid Arteries - surgery
carotid surgery
Economy. Management
Female
Health and social institutions
Humans
Intensive Care Units
Length of Stay
Male
Medical sciences
Public health. Hygiene
Public health. Hygiene-occupational medicine
Retrospective Studies
short stay
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Veterans
title Short Stay Carotid Surgery for Veterans: An Emerging Standard
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