Analysis of complications and causes of unexpected hospitalisation in ambulatory surgery

Unplanned inpatient admissions in a day surgery service in Hong Kong

“…The overall unplanned admission rate of 2% in this report is at the lower range of the reported series [6][7][8][9][10][11][12][13][14] and complies with the recommendation of the Royal College of Surgeons of England. 15 These admissions were mainly a result of minor postoperative events and no serious consequence was noted.…”

“…6 In many reported series, the commonest cause of unplanned admission was due to surgical reasons of which pain, haemorrhage, infection and extended surgery were frequently quoted. 6,10,[12][13][14] The present report has an unusually high percentage of admissions caused by extended operations. This might reflect the inaccuracy of preoperative diagnosis by the referring surgeons or their lack of understanding on the selection criteria for day case surgery.…”

“…However, a definite relationship between anaesthetic risk and unplanned admission has not been established. 6,14 Another reason is the limited variety of day operations that are performed in the centre. A day surgery service that is more aggressive in both patient and operation enrolment is likely to have a higher rate of complication and, thus, a higher admission rate.…”

“…Nausea and vomiting has consistently been a common reason for admission after day surgery. 10,13,14,18 Administration of prophylactic metocloprimide and the use of non-steroid, antiinflammatory drugs as pain control to avoid opiates are routine practice in our centre and nausea and vomiting has not been a significant cause of admission.…”

“…6 The rate of unplanned admissions varied from less than 1% to almost 10% in a published series. [6][7][8][9][10][11][12][13][14] The Royal College of Surgeons of England recommended an admission rate of less than 3% after day case surgery. 15 The present study aimed to analyse the causes of unplanned admissions in the first 4 years of a day surgery service at Tung Wah Hospital.…”