Introduction of a Post-Anaesthesia Care Unit in a Teaching Hospital Is Associated with a Reduced Length of Hospital Stay in Noncardiac Surgery: A Single-Centre Interrupted Time Series Analysis.

anaesthesia recovery period intensive care units operative post-anaesthesia care unit postoperative care postoperative complications surgical procedures

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
17 Jan 2024
Historique:
received: 18 12 2023
revised: 10 01 2024
accepted: 16 01 2024
medline: 23 1 2024
pubmed: 23 1 2024
entrez: 23 1 2024
Statut: epublish

Résumé

A post-anaesthesia care unit (PACU) may improve postoperative care compared with intermediate care units (IMCU) due to its dedication to operative care and an individualized duration of postoperative stay. The effects of transition from IMCU to PACU for postoperative care following intermediate to high-risk noncardiac surgery on length of hospital stay, intensive care unit (ICU) utilization, and postoperative complications were investigated. This single-centre interrupted time series analysis included patients undergoing eleven different noncardiac surgical procedures associated with frequent postoperative admissions to an IMCU or PACU between January 2018 and March 2019 (IMCU episode) and between October 2019 and December 2020 (PACU episode). Primary outcome was hospital length of stay, secondary outcomes included postoperative complications and ICU admissions. In total, 3300 patients were included. The hospital length of stay was lower following PACU admission compared to IMCU admission (IMCU 7.2 days [4.2-12.0] vs. PACU 6.0 days [3.6-9.1]; The introduction of a PACU for postoperative care of patients undergoing intermediate to high-risk noncardiac surgery was associated with a reduction in the length of stay at the hospital, without increasing postoperative complications.

Sections du résumé

BACKGROUND BACKGROUND
A post-anaesthesia care unit (PACU) may improve postoperative care compared with intermediate care units (IMCU) due to its dedication to operative care and an individualized duration of postoperative stay. The effects of transition from IMCU to PACU for postoperative care following intermediate to high-risk noncardiac surgery on length of hospital stay, intensive care unit (ICU) utilization, and postoperative complications were investigated.
METHODS METHODS
This single-centre interrupted time series analysis included patients undergoing eleven different noncardiac surgical procedures associated with frequent postoperative admissions to an IMCU or PACU between January 2018 and March 2019 (IMCU episode) and between October 2019 and December 2020 (PACU episode). Primary outcome was hospital length of stay, secondary outcomes included postoperative complications and ICU admissions.
RESULTS RESULTS
In total, 3300 patients were included. The hospital length of stay was lower following PACU admission compared to IMCU admission (IMCU 7.2 days [4.2-12.0] vs. PACU 6.0 days [3.6-9.1];
CONCLUSIONS CONCLUSIONS
The introduction of a PACU for postoperative care of patients undergoing intermediate to high-risk noncardiac surgery was associated with a reduction in the length of stay at the hospital, without increasing postoperative complications.

Identifiants

pubmed: 38256668
pii: jcm13020534
doi: 10.3390/jcm13020534
pii:
doi:

Types de publication

Journal Article

Langues

eng

Auteurs

Nick J Koning (NJ)

Department of Anesthesiology and Pain Medicine, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands.

Joost L C Lokin (JLC)

Department of Anesthesiology and Pain Medicine, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands.
Department of Anesthesiology, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands.

Lian Roovers (L)

Clinical Research Center, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands.

Jan Willem Kallewaard (JW)

Department of Anesthesiology and Pain Medicine, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands.
Department of Anesthesiology, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands.

Wim H van Harten (WH)

Clinical Research Center, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands.
Health Services & Technology Research, University of Twente, 7522 NB Enschede, The Netherlands.

Cor J Kalkman (CJ)

Department of Anesthesiology, University Medical Centre Utrecht, 3584 CX Utrecht, The Netherlands.

Benedikt Preckel (B)

Department of Anesthesiology, Amsterdam University Medical Centre, 1105 AZ Amsterdam, The Netherlands.

Classifications MeSH