Anesthesiologists reveal lack of consensus on patient selection criteria for ASCs — 4 study findings

Anesthesiologists disagree on which patients should be treated at ASCs versus a hospital inpatient or outpatient setting, according to a study reported by Ciproms Medical Billing.

Omaha-based University of Nebraska Medical Center researchers including Nebraska Medicine's Nicholas Heiser, MD, and Allyson Hascall, MD, conducted a formal survey of U.S. anesthesiologists after finding no discernable consensus on patient selection criteria among colleagues and existing literature.

Here's what you should know:

1. The study confirmed there is a great deal of variability in patient selection criteria at ASCs for conditions such as chronic obstructive pulmonary disease, congestive heart failure and pregnancy.

2. More than 90 percent of respondents were willing to perform surgeries on patients with body mass indexes greater than 35 kg/m2, stable coronary artery disease or insulin-dependent diabetes mellitus or cardiac pacemakers. Those were the only agreed-upon risk factors.

3. Researchers found similar variability among freestanding ASCs, non-freestanding ASCs and ones with overnight capacity, contrary to their expectations.

4. The data underscores the need for greater consensus on evidence-based selection criteria, especially as an increasing number of patients with challenging conditions are treated in the outpatient setting, researchers said.

"Anesthesiologists will be tasked with being the gatekeepers with respect to determining who is and who is not safe for outpatient surgery," Dr. Heiser said. "We believe this to be a pressing issue that requires the attention of our profession."

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