Prevalence and Variation in Hospital-Based, Acute Care and Serious Adverse Events within 30 Days of Outpatient Liposuction and Abdominoplasty
Methods/Technique: Using administrative data from California, Florida, and New York, we identified adult patients who underwent liposuction and/or abdominoplasty between 2009 and 2010. Our primary outcome was hospital based, acute care within 30 days of surgery. Observed rates were reported as events per 1,000 discharges. ASC-level observed-to-expected ratios (O:E) were then calculated using a multivariable logistic regression model to evaluate ASC performance.
Results/Complications: The final sample included 13,702 patients who underwent liposuction (41.7%), abdominoplasty (43.5%), or both procedures (14.9%) at 206 ASCs. For the overall sample, 657 (6.3%) patients experienced at least one hospital based, acute care event for a rate of 74.1 (69.1-79.5) events per 1,000 discharges. These events most frequently occurred in the emergency department without need for subsequent hospital admission; were due to complications of care; and were associated with a median charge of $2,694 per emergency department visit and $32,210 per admission. Wide variation was noted in the observed hospital based, acute care rates across ASCs (median=40.0/1,000 discharges [min=0/1,000, max=439/1,000]). After calculating O:E ratios, 2 (1.0%) ASCs performed better and 12 (5.8%) performed worse than would have been expected given their patient populations.
Conclusion: Though overall hospital based, acute care rates following outpatient liposuction and abdominoplasty are low, the patient experience varies widely across individual ASCs. Further evaluation of best practices at high performing centers may be warranted to improve the care of all patients.