Correspondencia: Hospital Universitari de Tarragona Joan XXIII. Unitat de Cirurgia Sense Ingrés (UCSI). Dr. Mallafré Guasch, 4. 43007 Tarragona. España.
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España" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio de Anestesiología y Reanimación. Hospital de Manacor. Mallorca. España" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Hospital Universitari de Tarragona Joan XXIII. Unitat de Cirurgia Sense Ingrés (UCSI). Dr. Mallafré Guasch, 4. 43007 Tarragona. España." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "National survey of preoperative management and patient selection in ambulatory surgery centers" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2002-08-29" "fechaAceptado" => "2003-02-25" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec268711" "palabras" => array:3 [ 0 => "Cirugía mayor ambulatoria" 1 => "Evaluación preoperatoria" 2 => "Indicadores de calidad" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec268712" "palabras" => array:3 [ 0 => "Ambulatory surgery" 1 => "Preoperative assessment" 2 => "Quality indicators" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio es conocer los criterios de selección y preparación de los pacientes en las diferentes unidades de cirugía mayor ambulatoria (UCMA) españolas y su impacto en los resultados de éstas; también se comparan dichos resultados según el tipo de estructura funcional de las unidades (autónoma o integrada).</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo transversal mediante encuesta postal. Encuesta con los siguientes apartados: tipo de unidad, cartera de servicios, criterios de selección, evaluación, manejo preoperatorio e indicadores cualitativos y cuantitativos de la actividad realizada en el año 2000. Se incluyeron 123 unidades, con un nivel de respuesta del 39%.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Existe un alto grado de consenso en los criterios de selección. En el 97,9% de las unidades se utiliza la consulta de anestesia para la evaluación preoperatoria. La solicitud sistemática de las pruebas de laboratorio es elevada (89% para la hemostasia y el hemograma, 72,9% para la bioquímica), mientras que para la radiografía de tórax (33,3%) y el ECG (35,4%) se utilizan criterios más selectivos. La implantación de protocolos para el manejo de afecciones asociadas está poco extendida (25-64,6%). El índice de cancelaciones es ventajoso para las unidades que utilizan la consulta de anestesia en todos los pacientes (el 1,5 frente al 4,4%). Existe una significativa aceptación de pacientes de mayor riesgo quirúrgico-anestésico en las unidades de tipo autónomo respecto a las integradas, así como una significativa disminución del número de ingresos (el 1,2 frente al 1,9%; p = 0,003) de las estancias (240 frente a 367 min; p = 0,002), y del tiempo de recuperación (150 frente a 212 min; p = 0,001). Las diferencias en el resto de los indicadores analizados no revisten significación.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Es necesario profundizar en la consecución de protocolos basados en evidencias científicas para la se-lección de los pacientes, la evaluación preoperatoria y el manejo perioperatorio de las diferentes enfermedades, así como para la utilización racional de las pruebas de laboratorio. Se constata la necesidad de la consulta anestésica para la evaluación preoperatoria. Los resultados de nuestra encuesta apuntan hacia unos mejores resultados en los indicadores de funcionamiento en las UCMA autónomas frente a las integradas. Existe la posibilidad de definir estándares de calidad y validarlos, para lo cual serán necesarios futuros estudios multicéntricos.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The objective of this study was to determine both the selection and preparation criteria in patients in various Spanish ambulatory surgery centers, as well as the impact of these criteria on their results. The results were compared according to the type of functional structure of the units (autonomous or integrated).</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We performed a cross sectional, descriptive study through postal survey. The survey contained the following items: type of unit, surgical procedures, selection criteria, preoperative assessment and management, and qualitative and quantitative indexes of the activity performed in 2000. A total of 123 units were included with a response rate of 39%.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The selection criteria showed a high degree of consensus. The outpatient anesthesia clinic was used for preoperative assessment by 97.9% of the units. Most units routinely requested preoperative tests (hemostasis and hemogram by 89%; biochemical parameters by 72.9%) and to a lesser extent chest X-ray (33.3%) and electrocardiogram (35.4%). The introduction of procedures for the management of coexisting diseases was scarce (25-64.6%). Units using the outpatient anesthesia clinic in all patients had a lower cancellation rate (1.5% vs 4.4%). Autonomous units were significantly more likely to accept patients with high surgical-anesthetic risk than integrated units. Autonomous units also showed a significantly lower number of admissions (1.2% vs 1.9%, p = 0.003), mean stay (240 min vs 367 min, p = 0.002), and recovery time (150 min vs 212 min, p = 0.001) than integrated units. No statistically significant differences were found in the remaining parameters.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Scientifically based protocols for patient selection, preoperative assessment and perioperative management of distinct processes and for the rational use of laboratory tests should be more widely used. The need for an outpatient anesthesia clinic for preoperative assessment was notable. The results of our survey indicate that better results in performance indexes are achieved in autonomous ambulatory surgery units than in integrated units. 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año/Mes | Html | Total | |
---|---|---|---|
2024 Noviembre | 8 | 6 | 14 |
2024 Octubre | 57 | 34 | 91 |
2024 Septiembre | 43 | 19 | 62 |
2024 Agosto | 40 | 36 | 76 |
2024 Julio | 32 | 28 | 60 |
2024 Junio | 39 | 15 | 54 |
2024 Mayo | 41 | 32 | 73 |
2024 Abril | 35 | 19 | 54 |
2024 Marzo | 39 | 20 | 59 |
2024 Febrero | 35 | 54 | 89 |
2024 Enero | 26 | 17 | 43 |
2023 Diciembre | 19 | 13 | 32 |
2023 Noviembre | 30 | 22 | 52 |
2023 Octubre | 20 | 15 | 35 |
2023 Septiembre | 29 | 14 | 43 |
2023 Agosto | 27 | 18 | 45 |
2023 Julio | 36 | 24 | 60 |
2023 Junio | 41 | 20 | 61 |
2023 Mayo | 27 | 21 | 48 |
2023 Abril | 27 | 14 | 41 |
2023 Marzo | 33 | 33 | 66 |
2023 Febrero | 25 | 11 | 36 |
2023 Enero | 22 | 21 | 43 |
2022 Diciembre | 33 | 34 | 67 |
2022 Noviembre | 39 | 39 | 78 |
2022 Octubre | 27 | 38 | 65 |
2022 Septiembre | 21 | 35 | 56 |
2022 Agosto | 35 | 47 | 82 |
2022 Julio | 23 | 41 | 64 |
2022 Junio | 26 | 32 | 58 |
2022 Mayo | 31 | 36 | 67 |
2022 Abril | 23 | 39 | 62 |
2022 Marzo | 25 | 46 | 71 |
2022 Febrero | 32 | 37 | 69 |
2022 Enero | 19 | 41 | 60 |
2021 Diciembre | 24 | 41 | 65 |
2021 Noviembre | 26 | 44 | 70 |
2021 Octubre | 24 | 39 | 63 |
2021 Septiembre | 17 | 50 | 67 |
2021 Agosto | 15 | 23 | 38 |
2021 Julio | 20 | 23 | 43 |
2021 Junio | 13 | 29 | 42 |
2021 Mayo | 17 | 32 | 49 |
2021 Abril | 37 | 42 | 79 |
2021 Marzo | 35 | 29 | 64 |
2021 Febrero | 24 | 15 | 39 |
2021 Enero | 19 | 21 | 40 |
2020 Diciembre | 21 | 18 | 39 |
2020 Noviembre | 17 | 15 | 32 |
2020 Octubre | 10 | 26 | 36 |
2020 Septiembre | 16 | 7 | 23 |
2020 Agosto | 8 | 12 | 20 |
2020 Julio | 7 | 16 | 23 |
2020 Junio | 7 | 6 | 13 |
2020 Mayo | 9 | 10 | 19 |
2020 Abril | 24 | 19 | 43 |
2020 Marzo | 22 | 11 | 33 |
2020 Febrero | 11 | 20 | 31 |
2020 Enero | 17 | 21 | 38 |
2019 Diciembre | 8 | 15 | 23 |
2019 Noviembre | 10 | 9 | 19 |
2019 Octubre | 10 | 4 | 14 |
2019 Septiembre | 5 | 6 | 11 |
2019 Agosto | 10 | 14 | 24 |
2019 Julio | 7 | 13 | 20 |
2019 Junio | 7 | 9 | 16 |
2019 Mayo | 8 | 21 | 29 |
2019 Abril | 8 | 7 | 15 |
2019 Marzo | 6 | 6 | 12 |
2019 Febrero | 11 | 9 | 20 |
2019 Enero | 4 | 9 | 13 |
2018 Diciembre | 5 | 9 | 14 |
2018 Noviembre | 19 | 19 | 38 |
2018 Octubre | 31 | 30 | 61 |
2018 Septiembre | 15 | 10 | 25 |
2018 Agosto | 16 | 14 | 30 |
2018 Julio | 29 | 10 | 39 |
2018 Junio | 25 | 10 | 35 |
2018 Mayo | 25 | 12 | 37 |
2018 Abril | 29 | 6 | 35 |
2018 Marzo | 18 | 4 | 22 |
2018 Febrero | 12 | 7 | 19 |
2018 Enero | 13 | 3 | 16 |
2017 Diciembre | 17 | 11 | 28 |
2017 Noviembre | 11 | 12 | 23 |
2017 Octubre | 11 | 11 | 22 |
2017 Septiembre | 11 | 6 | 17 |
2017 Agosto | 5 | 10 | 15 |
2017 Julio | 19 | 14 | 33 |
2017 Junio | 18 | 11 | 29 |
2017 Mayo | 24 | 12 | 36 |
2017 Abril | 17 | 9 | 26 |
2017 Marzo | 10 | 3 | 13 |
2017 Febrero | 8 | 5 | 13 |
2017 Enero | 5 | 11 | 16 |
2016 Diciembre | 24 | 8 | 32 |
2016 Noviembre | 24 | 9 | 33 |
2016 Octubre | 21 | 18 | 39 |
2016 Septiembre | 22 | 10 | 32 |
2016 Agosto | 28 | 13 | 41 |
2016 Julio | 16 | 6 | 22 |
2016 Mayo | 2 | 0 | 2 |
2016 Marzo | 2 | 0 | 2 |
2016 Febrero | 2 | 0 | 2 |
2015 Diciembre | 3 | 0 | 3 |
2015 Octubre | 2 | 0 | 2 |
2015 Septiembre | 1 | 0 | 1 |
2015 Julio | 1 | 0 | 1 |
2015 Junio | 1 | 0 | 1 |
2015 Abril | 2 | 0 | 2 |
2015 Marzo | 2 | 0 | 2 |
2015 Febrero | 3 | 0 | 3 |
2015 Enero | 3 | 0 | 3 |
2014 Diciembre | 6 | 0 | 6 |
2014 Noviembre | 5 | 1 | 6 |
2014 Octubre | 5 | 0 | 5 |
2014 Septiembre | 5 | 1 | 6 |
2014 Agosto | 7 | 1 | 8 |
2014 Julio | 7 | 1 | 8 |
2014 Junio | 7 | 1 | 8 |
2014 Mayo | 5 | 1 | 6 |
2014 Abril | 6 | 2 | 8 |
2014 Marzo | 5 | 2 | 7 |
2014 Febrero | 5 | 0 | 5 |
2014 Enero | 8 | 2 | 10 |
2013 Diciembre | 15 | 8 | 23 |
2013 Noviembre | 27 | 2 | 29 |
2013 Octubre | 45 | 2 | 47 |
2013 Septiembre | 21 | 4 | 25 |
2013 Agosto | 23 | 1 | 24 |
2013 Julio | 24 | 3 | 27 |
2003 Agosto | 1832 | 0 | 1832 |