Affordable Access

deepdyve-link
Publisher Website

Analysis of failed discharge after ambulatory surgery: unanticipated admission.

Authors
  • Van Caelenberg, Els1
  • De Regge, Melissa2, 3
  • Eeckloo, Kristof2, 4
  • Coppens, Marc1, 5
  • 1 a Ambulatory Surgery Centre, Ghent University Hospital , Ghent , Belgium. , (Belgium)
  • 2 b Strategic Policy Cell , Ghent University Hospital , Ghent , Belgium. , (Belgium)
  • 3 c Department of Innovation, Entrepreneurship, and Service Management, Faculty of Economics and Business Administration , Ghent University , Ghent , Belgium. , (Belgium)
  • 4 d Department of Public health, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium. , (Belgium)
  • 5 e Faculty of Medicine and Health Sciences, Anesthesiology and Perioperative Medicine , Ghent University , Ghent , Belgium. , (Belgium)
Type
Published Article
Journal
Acta Chirurgica Belgica
Publisher
Informa UK (Taylor & Francis)
Publication Date
Jun 01, 2019
Volume
119
Issue
3
Pages
139–145
Identifiers
DOI: 10.1080/00015458.2018.1477488
PMID: 29848193
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Advantages of ambulatory surgery are lost when patients need an unplanned admission. This retrospective cohort study investigated reasons for failed discharge and unanticipated admission of adult patients after day surgery. Ambulatory patients (n = 145) requiring unanticipated admission were compared to patients (n = 4980) not requiring admission and timely discharged from a total of 5156 ambulatory surgical procedures. Demographic data, organisational data, reason for admission, type of anesthesia, surgical discipline, length of procedure, ASA classification, surgical completion time and severity of illness score were collected from both groups. Reason for admission was classified according to four subtypes. Logistic regression analysis was used. Incidence of unanticipated admission following day care surgery was 2.89%. The reasons for admission were mainly organisational issues (45.52%), time of completion surgery in the afternoon between 12 pm and 3 pm (OR 1.73; 95% CI 1.05-2.86) and surgery that ends after 3 pm (OR 6.52; 95% CI 4.11-10.34). Surgical factors associated with unanticipated admission (38.62%) were length of surgery of one to three hours (OR 2.05; 95% CI 1.27-3.29), length of surgery more than three hours (OR 8.31; 95% CI 3.56-19.40). Additionally, anaesthetic (10.34%) and medical (5.52%) reasons were found, e.g. ASA class II (OR 1.61; 95% CI 1.06-2.44), ASA class III (OR 2.19; 95% CI 1.10-4.34); moderate severity of illness score (OR 1.72; 95% CI 1.03-2.88) and major of severity of illness score (OR 7.85; 95% CI 2.31-26.62). Unanticipated admissions following day surgery occur mainly due to social/organisational and surgical reasons. However, medical and anaesthetic reasons also explain 15.86% of the unanticipated admissions.

Report this publication

Statistics

Seen <100 times