POSTANESTHESIA CARE UNIT LENGTH OF STAY - QUANTIFYING AND ASSESSING DEPENDENT FACTORS

Postanesthesia care unit (PACU) monitoring reduces morbidity and is th e standard of care for postsurgical patients. PACUs require large nurs e to patient ratios, which contributes to the cost of care. Despite th e importance and cost of PACU length of stay (LOS), no standards have been established. We performed an observational study of 340 PACU pati ents to measure actual and medically appropriate PACU LOS (the time re quired to achieve a medically stable condition for safe PACU discharge ), to identify factors related to LOS, and to create a LOS prediction index. Mean (+/- so) actual LOS was 95 +/- 43 min, and appropriate PAC U LOS was 71 +/- 37 min. Appropriate PACU LOS predictors were anesthet ic time, anesthetic technique, and amount of intraoperative fluids. Ac tual LOS was >30 min longer than the medically appropriate LOS for 20% (68 of 340) of the patients. Frequent causes of excessive LOS were wa iting for physician release or laboratory or radiographic results. App ropriate LOS may be related primarily to anesthetic factors, and nonme dical issues account for a significant amount of PACU LOS. Implication s: Most patients are stabilized immediately after surgery in a postane sthesia care unit (PACU) until their discharge to a hospital ward. How ever, there are no standards for appropriate PACU length of stay (LOS) . In this study, we measured actual and appropriate PACU LOSs and eval uated clinical factors that may influence PACU LOS.