Factors determining length of stay of surgical day-case patients

Background and objective Factors which lead to prolonged stay in the day-ca re unit and unplanned admission after day-case surgery are poorly understoo d. Methods Data sets of 3152 day-case patients were collected with a computeri zed online record keeping system (NarkoData). Predictors of prolonged posto perative stay including unanticipated admission were identified using univa riate analysis. Charts of patients, who needed admission, were reviewed. Results 13.2% of day-case patients had a postoperative stay less than or eq ual to3 h, 55.3% 3-6 h and 26.2% greater than or equal to 6 h. 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 durat ion 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. Ch art review of patients admitted to hospital confirmed the validity of the s tatistically significant predictors. Conclusions In day-case surgery, the predictors of prolonged stay in the da y-care unit and unplanned Hospital admission are mainly related to the surg ical procedure.