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October, 2005

The study detailed the American Association for Accreditation of Ambulatory Surgery Facilities' ongoing Internet-based peer-review program, which has analyzed 872,115 procedures between 2001 and 2004. Patient deaths occurred in 16 of those procedures, says Geoffrey R. Keyes, MD, a Los Angeles-based plastic and reconstructive surgeon and AAAASF board member. Dr. Keyes presented the study results at last month's American Society of Plastic Surgeons meeting in Chicago.

Dr. Keyes notes that 10 of the 16 deaths were the result of pulmonary emboli. "Pulmonary emboli occur in inpatient as well as outpatient settings," notes Dr. Keyes. "It's a problem in all of surgery and we will be conducting studies to lessen its occurrence."

To this point, the most publicized study of office-based surgery was a damning one, the seminal Archives of Surgery study in which researchers found the risk of adverse incidents and death in Florida surgical offices was 10 times that of the state's ASCs.

Surgeons operating in the country's 1,250 AAAASF-accredited office surgery facilities must be board certified in the specialty for which they operate and must be credentialed to perform the same procedure in a hospital. They're required to report all unanticipated sequelae into the Internet program, and to enter random case reviews twice a year, says Dr. Keyes, who notes that unanticipated sequelae occurred in one of 299 cases studied. Last year, AAAASF required its accredited facilities that administer propofol to upgrade to Class C (general anesthesia facilities).

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