Comparison of complication rates following elective arthroscopy performed as inpatient versus outpatient surgery in horses

OBJECTIVE To report complication rates following elective arthroscopy in horses and determine whether postoperative complication rates are higher for outpatient procedures, compared with inpatient procedures. DESIGN Retrospective cohort study. ANIMALS 357 client-owned horses that had undergone 366 elective arthroscopic procedures between January 2008 and February 2015. PROCEDURES Medical records were retrospectively reviewed. Data collected included signalment, travel time to the hospital, clinical signs, joints treated, lesions diagnosed, medications administered, anesthesia and surgery times, details of the procedure (including closure method and surgeons involved), and hospitalization status (inpatient or outpatient). Inpatients were horses that remained hospitalized overnight, and outpatients were horses that were discharged in the afternoon of the day of surgery. The collected data were analyzed along with follow-up information to identify factors associated with postoperative complications and potentially associated with hospitalization status. RESULTS Data were collected on 366 elective arthroscopic procedures (outpatient, n = 168 [46%]; inpatient, 198 [54%]). Complications that occurred included bandage sores, catheter problems, colic, diarrhea, postoperative discomfort, esophageal impaction, fever, incisional drainage, postanesthetic myopathy, persistent synovitis, persistent lameness, septic arthritis, and osteochondral fragments not removed during the original surgery. None of these complications were associated with hospitalization status (outpatient vs inpatient). However, Standardbreds were overrepresented in the outpatient group, and anesthesia and surgery times were longer for the inpatient group. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that outpatient elective arthroscopy in healthy horses could be performed safely and without a higher risk of complications, compared with similar procedures performed on an inpatient basis.