{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:43:46Z","timestamp":1740109426058,"version":"3.37.3"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Unplanned overnight admission (UOA) is an important indicator for quality of care with ambulatory knee arthroscopic surgery (AKAS). However, few studies have explored the factors related to the UOA and how to predict UOA after AKAS. This study aimed to evaluate the effectiveness of a standardized peri-operative protocol for the AKAS and identify whether a correlation exists between the peri-operative surgical factors and UOA in the patients undergoing AKAS. We hypothesized that more surgical invasiveness and prolong tourniquet time increase the risk of UOA after AKAS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>A prospective cohort study was conducted between October 2017 and March 2021. All 184 patients operated on standard AKAS protocol. The UOA is defined as overnight hospitalization of a patient undergoing AKAS. Demographic and peri-operative data were recorded, and the procedure was categorized based on the surgical invasiveness based on less invasive (intra-articular soft tissue surgery) (<jats:italic>n<\/jats:italic>\u2009=\u200965) and more complex surgery (involving extra-articular soft tissue surgery or ligamentous reconstruction) (<jats:italic>n<\/jats:italic>\u2009=\u2009119). The clinical risk factors for UOA were identified and analyzed with multivariate analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The incidence of UOA in the more complex group (<jats:italic>n<\/jats:italic>\u2009=\u20097, 14.3%) was significantly higher than in the less invasive group (<jats:italic>n<\/jats:italic>\u2009=\u20093, 4.6%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.049). The peri-operative factors significantly associated with UOA were age, more complex surgery, and longer tourniquet time (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.10 all). However, the multivariate analysis revealed that longer tourniquet time was the only significant predictor for UOA (OR\u2009=\u20091.045, 95% CI\u2009=\u20091.022\u20131.067, <jats:italic>p<\/jats:italic>\u2009=\u20090.0001). The optimal cut-off points of tourniquet time for predicting UOA with the highest Youden index in the less invasive and more complex groups were 56\u00a0minutes and 107\u00a0minutes, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The UOA after AKAS is more common in more complex surgery compared to less invasive surgery. This study showed that unplanned admission significantly associated with many factors\u2014as patient factors, surgical invasiveness, and tourniquet time. However, tourniquet time is the only independent predictor for UOA. Therefore, strict perioperative management protocol must be applied in AKAS, and all patients having these risk factors should be prepared for UOA.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00264-022-05436-8","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T03:47:50Z","timestamp":1652759270000},"page":"1991-1998","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predicting surgical factors for unplanned overnight admission in ambulatory arthroscopic surgery of the knee: a prospective cohort in one hundred and eighty four patients"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0359-5703","authenticated-orcid":false,"given":"Nadhaporn","family":"Saengpetch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ratthapoom","family":"Watcharopas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chusak","family":"Kujkunasathian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chalermchai","family":"Limitloahaphan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chatchawan","family":"Lertbutsayanukul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaiyanun","family":"Vijittrakarnrung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paphon","family":"Sa-ngasoongsong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanlapa","family":"Arnuntasupakul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Sangkum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"issue":"11","key":"5436_CR1","doi-asserted-by":"publisher","first-page":"994","DOI":"10.2106\/JBJS.I.01618","volume":"93","author":"S Kim","year":"2011","unstructured":"Kim S, Bosque J, Meehan JP, Jamali A, Marder R (2011) Increase in outpatient knee arthroscopy in the United States: a comparison of National Surveys of Ambulatory Surgery, 1996 and 2006. 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All patients were appropriately informed and gave consent before participating in this study and certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}