Background: Catastrophic outcomes of outpatient plastic surgery such as septic shock, myocardial infarction, and death are rare. Few studies have provided robust data on risk factors associated with these events. This study utilizes an independent, multicenter database to investigate the incidence and predictive factors of catastrophic outcomes associated with outpatient plastic surgery. Methods: Patients in the National Surgical Quality Improvement Program (NSQIP) participant use database who underwent outpatient plastic surgery between 2006 and 2010 were identified. Demographic information for patients and rates of catastrophic outcomes within 30 days of surgery (sepsis/septic shock, pulmonary embolism, stroke, myocardial infarction (MI), cardiac arrest, coma, and death) was determined. Results: Over the 5-year study period, 10,954 patients underwent an outpatient plastic surgery procedure. Thirty-one patients presented with catastrophic outcomes (0.28 %). These patients had a total of 34 catastrophic outcomes: 20 sepsis/septic shock (58.8 %), 5 pulmonary embolism (14.7 %), 3 stroke (8.8 %), 2 cardiac arrest (5.9 %), and 4 death (11.7 %). No occurrences of MI or coma were reported. Conclusions: Outpatient plastic surgery can be performed safely in accredited ambulatory facilities as demonstrated by the overall 0.28 % catastrophic outcome rate garnered from a 5-year review of the NSQIP database. Level of Evidence: Level III, prognostic/risk study.
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