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Factors determining length of stay of surgical day-case patients

Published online by Cambridge University Press:  16 August 2006

A. Junger ,
J. Klasen ,
M. Benson ,
G. Sciuk ,
B. Hartmann ,
J. Sticher  and
G. Hempelmann
A. Junger
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig University Giessen, Germany
J. Klasen
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig University Giessen, Germany
M. Benson
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig University Giessen, Germany
G. Sciuk
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig University Giessen, Germany
B. Hartmann
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig University Giessen, Germany
J. Sticher
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig University Giessen, Germany
G. Hempelmann
Affiliation:
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig University Giessen, Germany
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Abstract

Background and objective Factors which lead to prolonged stay in the day–care unit and unplanned admission after day-case surgery are poorly understood.

Methods Data sets of 3152 day-case patients were collected with a computerized online record keeping system (NarkoData). Predictors of prolonged postoperative stay including unanticipated admission were identified using univariate analysis. Charts of patients, who needed admission, were reviewed.

Results 13.2% of day–case patients had a postoperative stay ≤3 h, 55.3% 3–6 h and 26.2%≥6h. The rate of unanticipated admission was 5.4%. Intraoperative haemoglobin concentration and blood loss were the best predictors of a prolonged postoperative stay. Other significant predictors were female gender, advanced age, longer duration of surgery, larger volume of infusions, intubation, spinal anaesthesia, intraoperative use of opioids and non–depolarizing muscle relaxants, high pain score, nausea and vomiting and prolonged preoperative waiting time. Chart review of patients admitted to hospital confirmed the validity of the statistically significant predictors.

Conclusions In day-case surgery, the predictors of prolonged stay in the day-care unit and unplanned Hospital admission are mainly related to the surgical procedure.

Keywords

surgical proceduresoperativeambulatory surgical procedurespatient carehospitalizationpatient readmissionforecastingmedical informaticsmedical informatics applicationsinformation systemsmanagement information systemsambulatory care information systems
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 18 , Issue 5 , May 2001 , pp. 314 - 321
Copyright
2001 European Society of Anaesthesiology

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