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Safety of day-case endoscopic sinus surgery in England: An observational study using an administrative dataset
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  • Annakan Navaratnam,
  • Alfonso Pendolino,
  • Peter J Andrews,
  • Hesham Saleh,
  • Claire Hopkins,
  • prem randhawa,
  • Sarah Little,
  • Jamie Day,
  • Tim Briggs,
  • William Gray
Annakan Navaratnam
Imperial College Healthcare NHS Trust

Corresponding Author:[email protected]

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Alfonso Pendolino
Royal National Throat Nose and Ear Hospital
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Peter J Andrews
University College London Hospitals NHS Foundation Trust
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Hesham Saleh
Charing Cross Hospital
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Claire Hopkins
Guy's and St Thomas' Hospitals NHS Trust
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prem randhawa
Royal National Throat Nose and Ear Hospital
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Sarah Little
St Georges’ Hospital
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Jamie Day
NHS England and NHS Improvement London
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Tim Briggs
NHS England and NHS Improvement London
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William Gray
NHS England and NHS Improvement London
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Abstract

Background: As elective surgical services recover from the COVID-19 pandemic a movement towards day-case surgery may reduce waiting lists. However, evidence is needed to show that day-case surgery is safe for many ENT operations including endoscopic sinus surgery (ESS). We aimed to investigate the safety of ESS in England. Methods: This was an observational, secondary analysis of administrative data. Participants were all patients in England undergoing elective ESS procedure aged ≥ 17 years during for the five years from 1st April 2014 to 31st March 2019. The exposure variable was day-case or overnight stay. The primary outcome was emergency readmission within 30 days post-discharge. Results: Data were available for 49,223 patients operated on across 129 NHS hospital trusts. In trusts operating on more than 50 patients in the study period, rates of day-case surgery varied from 100% to 20.6%. Rates of day-case surgery increased from 64.0% in 2014/15 to 78.7% in 2018/19. Day-case patients had lower rates of 30-day emergency readmission (odds ratio 0.71, 95% confidence interval 0.62 to 0.81). For secondary outcomes measures, there was no evidence of poorer outcomes for day-case patients. Outcomes for patients operated on in trusts with ≥80% day-case rates compared to patients operated on in trusts with <50% rates of day-case surgery were similar. Conclusions: ESS can safely be performed as day-case surgery at current rates. There is a potential to increase rates of day-case ESS in England, especially in departments that currently have low rates of day-case ESS.
12 Jul 2022Submitted to Clinical Otolaryngology
21 Jul 2022Submission Checks Completed
21 Jul 2022Assigned to Editor
13 Aug 2022Reviewer(s) Assigned
21 Aug 2022Review(s) Completed, Editorial Evaluation Pending
28 Aug 2022Editorial Decision: Revise Major
22 Sep 20221st Revision Received
26 Sep 2022Submission Checks Completed
26 Sep 2022Assigned to Editor
28 Sep 2022Reviewer(s) Assigned
05 Oct 2022Review(s) Completed, Editorial Evaluation Pending
09 Oct 2022Editorial Decision: Revise Minor
31 Oct 20222nd Revision Received
01 Nov 2022Submission Checks Completed
01 Nov 2022Assigned to Editor
02 Nov 2022Reviewer(s) Assigned
05 Nov 2022Review(s) Completed, Editorial Evaluation Pending
05 Nov 2022Editorial Decision: Accept
21 Nov 2022Published in Clinical Otolaryngology. 10.1111/coa.14006