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Unplanned hospital admission in children undergoing day-case surgery

Published online by Cambridge University Press:  23 December 2004

I. T. Awad ,
M. Moore ,
C. Rushe ,
A. Elburki ,
K. O'Brien  and
D. Warde
I. T. Awad
Affiliation:
The Children's University Hospital, Department of Anaesthesia and Intensive Care Medicine, Dublin, Republic of Ireland
M. Moore
Affiliation:
The Children's University Hospital, Department of Anaesthesia and Intensive Care Medicine, Dublin, Republic of Ireland
C. Rushe
Affiliation:
The Children's University Hospital, Department of Anaesthesia and Intensive Care Medicine, Dublin, Republic of Ireland
A. Elburki
Affiliation:
The Children's University Hospital, Department of Anaesthesia and Intensive Care Medicine, Dublin, Republic of Ireland
K. O'Brien
Affiliation:
The Children's University Hospital, Department of Anaesthesia and Intensive Care Medicine, Dublin, Republic of Ireland
D. Warde
Affiliation:
The Children's University Hospital, Department of Anaesthesia and Intensive Care Medicine, Dublin, Republic of Ireland
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Abstract

Summary

Background and objective: Unplanned hospital admission is a measure of quality of care in the setting of day-case surgery. We set out to identify the incidence and causes of unplanned hospital admission in a paediatric day-case unit.

Methods: A retrospective survey to determine the incidence and causes of unplanned hospital admissions in children undergoing day-case surgery. The survey covered the period from January 1996 until December 1999 inclusive in a university affiliated children’s hospital. This hospital is the second largest paediatric referral centre in Ireland with total admissions across all specialities during the study period of 42 738.

Results: During the study period 10 772 children underwent day-case surgery, of whom 242 (2.2%) experienced unplanned hospital admission. The reasons for admission were surgical 146 (54%), anaesthetic 44 (16%), social 38 (14%), medical 31 (11%) and unclassified 10 (4%). Pain, surgical complications and/or further management, admission for observation, extensive surgery and oozing were the commonest surgical reasons. Postoperative nausea and vomiting, anaesthetic-related complication and somnolence were the commonest anaesthetic causes responsible for admission. Surgery performed after 15:00 h was an important factor associated with admission for social reasons. Orthopaedic surgery accounted for the largest absolute number of unplanned admissions with 61 (25%), followed by urology with 46 (19%) and general surgery with 46 (19%). However, measured as percentage of caseload, urology had the highest proportion of unplanned hospital admissions.

Conclusion: This study demonstrated that the incidence and causes of unplanned hospital admission following day-case surgery in children are similar to those for adults.

Keywords

AMBULATORY SURGICAL PROCEDURESPAEDIATRICSPATIENT CARE, hospitalization, patient readmission
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 5 , May 2004 , pp. 379 - 383
Copyright
2004 European Society of Anaesthesiology

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