PROLONGED RECOVERY STAY AND UNPLANNED ADMISSION OF THE PEDIATRIC SURGICAL OUTPATIENT - AN OBSERVATIONAL STUDY

Study Objective: To determine the incidence of and reasons for prolong ed length of stay in the postanesthesia care unit and unplanned hospit al admissions of children scheduled for outpatient surgery. Design: Pr ospective, observational cohort study. Setting: C. S. Mott Children's Hospital, a tertiary care setting. Patients: 168 ASA physical status I , II, and III children (birth to 18 years), 130 of whom experienced a prolonged length of stay and 61 who had an unplanned hospital admissio ns. Measurements and Main Results: 3.9% of annual outpatient populatio n experienced a prolonged length of stay, and 1.9% had an unplanned ou tpatient admission. Prolonged length of stay was most commonly due to postoperative nausea and vomiting (19%) or respiratory complications ( 16%), whereas unplanned hospital admissions were primarily SW respirat ory or surgical reasons (32% and 30%, respectively). Higher ASA status had a significant direct relationship with the incidence of unplanned outpatient admission and respiratory complications. Although most fam ilies were satisfied with the length of their child's care, 28% of par ents whose children, were sent home after a prolonged length of stay w ould have preferred a short hospital admission, and 16% of parents of children with an unplanned hospital admission would have preferred a l onger stay in recovery and discharge home. Conclusion: Prolonged lengt h of stay and unplanned hospital admissions were uncommon outcomes fol lowing pediatric outpatient surgery. However, the impact of such outco mes on hospital staffing and family! convenience may have implications related to cost containment and patient satisfaction. (C) 1998 by Els evier Science Inc.