Therapeutic Endoscopy Can Be Performed Safely in an Ambulatory Surgical Center: A Multicenter, Prospective Study
Table 3
Outcomes and cost for inpatient versus ASC ERCP, EUS, and the total population.
ERCP
EUS
Total
IN
ASC
ALL
(95% CI)
IN
ASC
ALL
(95% CI)
IN
ASC
ALL
(95% CI)
Outcomes
Postprocedural complications
10 (13%)
12 (8%)
18 (8%)
0.20
1 (5%)
4 (3%)
5 (4%)
0.60
11 (11%)
16 (6%)
27 (7%)
0.11
Pancreatitis
7 (9%)
11 (7%)
18 (8%)
0.60
1 (5%)
3 (3%)
4 (3%)
0.20
8 (8%)
14 (5%)
22 (6%)
0.43
Hemorrhage
3 (4%)
1 (1%)
4 (2%)
0.25
0
1 (1%)
1 (1%)
0.98
3 (3%)
2 (0.7%)
5 (1%)
0.92
Perforation
0
0
0
1.00
0
0
0
1.00
0
0
0
1.00
Mortality
All-cause
7 (9%)
1 (1%)
8 (3%)
0.01
1 (5%)
2 (2%)
3 (2%)
0.12
9 (9%)
3 (1%)
12 (3%)
0.09
Service call
Fevers
7 (9%)
2 (1%)
9 (4%)
0.02
2 (9%)
2 (2%)
4 (3%)
1.00
9 (9%)
4 (1%)
13 (4%)
0.047
Nausea/vomiting
8 (11%)
17 (11%)
25 (11%)
0.87
0
7 (6%)
7 (5%)
0.98
8 (8%)
24 (9%)
32 (9%)
0.79
Abdominal pain
16 (21%)
37 (23%)
53 (23%)
0.41
2 (9%)
11 (9%)
13 (9%)
0.98
18 (18%)
48 (17%)
66 (18%)
0.13
Medical care
ED
2 (3%)
5 (3%)
7 (3%)
0.60
0
2 (2%)
2 (%)
0.94
2 (2%)
7 (3%)
9 (2%)
0.70
Urgent care
1 (1%)
2 (1%)
3 (1%)
1.00
0
0
0
1.00
1 (1%)
2 (1%)
3 (1%)
0.90
Hospitalization
1 (1%)
4 (3%)
5 (2%)
0.32
0
2 (2%)
2 (1%)
0.94
1 (1%)
6 (2%)
7 (2%)
0.34
LOS
9.3
0.6
3.6
<0.0001
4.4
0.7
2.8
0.21
8.7
0.8
2.8
<0.0001
Readmission
8 (11%)
10 (6%)
18 (8%)
0.04
1 (5%)
10 (9%)
11 (8%)
0.80
9 (19%)
20 (7%)
29 (8%)
0.17
Cost
Procedure
489.60
474.30
490.70
0.12
339.10
292.20
438.40
0.35
482.30
423.20
438.40
<0.0001
Total
19,022.90
1,574.30
7,662.80
<0.0001
9,196.30
1,668.90
6,082.20
0.21
17,815.70
2,026.90
6,082.20
<0.0001
ERCP: endoscopic retrograde cholangiopancreatography; EUS: endoscopic ultrasound; IN: inpatients; ASC: ambulatory surgical center patients; ALL: inpatients + ASC patients; ARDS: acute respiratory distress syndrome; CI: confidence interval; SIRS: systemic inflammatory response syndrome; MOF: multiple organ failure; MI: myocardial infarction; ED: emergency department; LOS: length of stay. Note that is significant. Inpatient that suffered cardiac arrest or respiratory failure was found to have septic shock and mild pancreatitis on day 21 after ERCP. A second inpatient after cancer surgery died of septic shock. ASC admitted on day 28 with pancreatitis or respiratory failure was DNR/DNI but family desired to be made hospice. ASC admitted with septic/cardiogenic shock after surgery for cancer. Note that no urgent care visits were hospitalized. Note that all hospitalizations were sent from a call to the service or directly from the endoscopy unit to the ED.
