Determinants of inappropriate hospitalization in cataract surgery in the south of Italy: a retrospective study

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Abstract

Purpose To analyze the frequency of inappropriate hospitalization in cataract surgery and the type of related determinants.Methods A nested retrospective case–control study was carried out on 2708 consecutive cataract surgery patients operated between January 2013 and Decem- ber 2015. All cases with inappropriate hospitalization (day surgery or ordinary hospitalization) were com- pared with a control group of cases treated in an appropriate (day service) regimen. The predictive value for inappropriate admissions to the hospital was assessed using a logistic regression model. Significant variables from the univariate analysis were included in a multivariate model.Results Forty-five cases (\ 2%) of inappropriate hospital admissions were recorded. Residence, heart disease, tremors, anticoagulants, intraoperative floppy iris syndrome were not related to appropriateness, while psychotic disorder (OR 12.571, p = 0.018), anxiety-depressive syndrome (OR 7.818, p = 0.010) and use of antipsychotropic drugs (OR 7.724, p = 0.002) were related to the inappropriateness of admission by univariate and multivariate analysis. Previous systemic surgeries were predictors of ordi- nary hospitalization by logistic regression analysis. A greater presence of hypertension, diabetes mellitus and fellow eye pseudophakia was noticed in appro- priate hospitalization cases.Conclusions This study detects the predictive role of psychiatric disorders as determinants of hospitaliza- tion inappropriateness in cataract surgery. The nega- tive correlation between inappropriate hospitalization and conditions such as hypertension and diabetes points out that in the elderly population common diseases are effectively addressed, in contrast to the difficult management of psychiatric patients. Prior systemic interventions represent factors inducing transfer from day service to ordinary hospitalization, highlighting communication problems related to dif- ficult coping with an outpatient surgery setting.
Lingua originaleEnglish
pagine (da-a)873-881
Numero di pagine9
RivistaInternational Ophthalmology
Volume39
Stato di pubblicazionePublished - 2019

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Cataract
Italy
Hospitalization
Retrospective Studies
Logistic Models
Ambulatory Surgical Procedures
Psychiatry
Pseudophakia
Hypertension
Transfer Factor
Tremor
Iris
Depressive Disorder
Psychotic Disorders
Anticoagulants
Heart Diseases
Diabetes Mellitus
Multivariate Analysis
Anxiety
Communication

All Science Journal Classification (ASJC) codes

  • Ophthalmology

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@article{93812ad7191f458eae50303f277e23b7,
title = "Determinants of inappropriate hospitalization in cataract surgery in the south of Italy: a retrospective study",
abstract = "Purpose To analyze the frequency of inappropriate hospitalization in cataract surgery and the type of related determinants.Methods A nested retrospective case–control study was carried out on 2708 consecutive cataract surgery patients operated between January 2013 and Decem- ber 2015. All cases with inappropriate hospitalization (day surgery or ordinary hospitalization) were com- pared with a control group of cases treated in an appropriate (day service) regimen. The predictive value for inappropriate admissions to the hospital was assessed using a logistic regression model. Significant variables from the univariate analysis were included in a multivariate model.Results Forty-five cases (\ 2{\%}) of inappropriate hospital admissions were recorded. Residence, heart disease, tremors, anticoagulants, intraoperative floppy iris syndrome were not related to appropriateness, while psychotic disorder (OR 12.571, p = 0.018), anxiety-depressive syndrome (OR 7.818, p = 0.010) and use of antipsychotropic drugs (OR 7.724, p = 0.002) were related to the inappropriateness of admission by univariate and multivariate analysis. Previous systemic surgeries were predictors of ordi- nary hospitalization by logistic regression analysis. A greater presence of hypertension, diabetes mellitus and fellow eye pseudophakia was noticed in appro- priate hospitalization cases.Conclusions This study detects the predictive role of psychiatric disorders as determinants of hospitaliza- tion inappropriateness in cataract surgery. The nega- tive correlation between inappropriate hospitalization and conditions such as hypertension and diabetes points out that in the elderly population common diseases are effectively addressed, in contrast to the difficult management of psychiatric patients. Prior systemic interventions represent factors inducing transfer from day service to ordinary hospitalization, highlighting communication problems related to dif- ficult coping with an outpatient surgery setting.",
author = "Giovanni Cillino and Walter Mazzucco and Alessandra Casuccio and Domenica Matranga and Salvatore Cillino and Fanny Pojero and Aissa Iggui and {Di Naro}, Simona",
year = "2019",
language = "English",
volume = "39",
pages = "873--881",
journal = "International Ophthalmology",
issn = "0165-5701",
publisher = "Springer Netherlands",

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TY - JOUR

T1 - Determinants of inappropriate hospitalization in cataract surgery in the south of Italy: a retrospective study

AU - Cillino, Giovanni

AU - Mazzucco, Walter

AU - Casuccio, Alessandra

AU - Matranga, Domenica

AU - Cillino, Salvatore

AU - Pojero, Fanny

AU - Iggui, Aissa

AU - Di Naro, Simona

PY - 2019

Y1 - 2019

N2 - Purpose To analyze the frequency of inappropriate hospitalization in cataract surgery and the type of related determinants.Methods A nested retrospective case–control study was carried out on 2708 consecutive cataract surgery patients operated between January 2013 and Decem- ber 2015. All cases with inappropriate hospitalization (day surgery or ordinary hospitalization) were com- pared with a control group of cases treated in an appropriate (day service) regimen. The predictive value for inappropriate admissions to the hospital was assessed using a logistic regression model. Significant variables from the univariate analysis were included in a multivariate model.Results Forty-five cases (\ 2%) of inappropriate hospital admissions were recorded. Residence, heart disease, tremors, anticoagulants, intraoperative floppy iris syndrome were not related to appropriateness, while psychotic disorder (OR 12.571, p = 0.018), anxiety-depressive syndrome (OR 7.818, p = 0.010) and use of antipsychotropic drugs (OR 7.724, p = 0.002) were related to the inappropriateness of admission by univariate and multivariate analysis. Previous systemic surgeries were predictors of ordi- nary hospitalization by logistic regression analysis. A greater presence of hypertension, diabetes mellitus and fellow eye pseudophakia was noticed in appro- priate hospitalization cases.Conclusions This study detects the predictive role of psychiatric disorders as determinants of hospitaliza- tion inappropriateness in cataract surgery. The nega- tive correlation between inappropriate hospitalization and conditions such as hypertension and diabetes points out that in the elderly population common diseases are effectively addressed, in contrast to the difficult management of psychiatric patients. Prior systemic interventions represent factors inducing transfer from day service to ordinary hospitalization, highlighting communication problems related to dif- ficult coping with an outpatient surgery setting.

AB - Purpose To analyze the frequency of inappropriate hospitalization in cataract surgery and the type of related determinants.Methods A nested retrospective case–control study was carried out on 2708 consecutive cataract surgery patients operated between January 2013 and Decem- ber 2015. All cases with inappropriate hospitalization (day surgery or ordinary hospitalization) were com- pared with a control group of cases treated in an appropriate (day service) regimen. The predictive value for inappropriate admissions to the hospital was assessed using a logistic regression model. Significant variables from the univariate analysis were included in a multivariate model.Results Forty-five cases (\ 2%) of inappropriate hospital admissions were recorded. Residence, heart disease, tremors, anticoagulants, intraoperative floppy iris syndrome were not related to appropriateness, while psychotic disorder (OR 12.571, p = 0.018), anxiety-depressive syndrome (OR 7.818, p = 0.010) and use of antipsychotropic drugs (OR 7.724, p = 0.002) were related to the inappropriateness of admission by univariate and multivariate analysis. Previous systemic surgeries were predictors of ordi- nary hospitalization by logistic regression analysis. A greater presence of hypertension, diabetes mellitus and fellow eye pseudophakia was noticed in appro- priate hospitalization cases.Conclusions This study detects the predictive role of psychiatric disorders as determinants of hospitaliza- tion inappropriateness in cataract surgery. The nega- tive correlation between inappropriate hospitalization and conditions such as hypertension and diabetes points out that in the elderly population common diseases are effectively addressed, in contrast to the difficult management of psychiatric patients. Prior systemic interventions represent factors inducing transfer from day service to ordinary hospitalization, highlighting communication problems related to dif- ficult coping with an outpatient surgery setting.

UR - http://hdl.handle.net/10447/279606

M3 - Article

VL - 39

SP - 873

EP - 881

JO - International Ophthalmology

JF - International Ophthalmology

SN - 0165-5701

ER -