Is Regional Anesthesia Associated With Reduced PACU Length of Stay?

Corey, John M.; Bulka, Catherine M.; Ehrenfeld, Jesse M.

doi:10.1007/s11999-013-3336-5

Cited by 20 publications

(19 citation statements)

References 16 publications

(23 reference statements)

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“…15 Having previously evaluated RA and time to postanesthesia care unit discharge, we now focus on the impact of RA compared to GA on time to hospital discharge and in-hospital mortality among patients admitted to the hospital after surgery. 16 …”

Section: Discussionmentioning

confidence: 99%

Regional Anesthesia, Time to Hospital Discharge, and In-Hospital Mortality

Bulka

Shotwell

Gupta

et al. 2014

Regional Anesthesia and Pain Medicine

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Section: Discussionmentioning

confidence: 99%

Regional Anesthesia, Time to Hospital Discharge, and In-Hospital Mortality

Bulka

Shotwell

Gupta

et al. 2014

Regional Anesthesia and Pain Medicine

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“…Previously, several studies have revealed risk factors for prolonged PACU LOS in various surgical populations [16] [22]. These studies suggest the need to focus on a special subset of patients as a way of reducing research bias [21], rather than focusing on all patients scheduled for surgery with general anesthesia [20].…”

Section: Discussionmentioning

confidence: 99%

“…Predictors for prolonged PACU LOS such as speci c anesthesia type, surgical specialty, scheduled surgery duration, postoperative opioid administration, morbid obesity, hypertension, obstructive sleep apnoea have been described in different populations [16] [17] [18] [19] [20] [21] [22]. The studies in most cases assessed outpatients [16] [21], pediatric populations [17] [18] [19], or all adult surgical patients undergoing general anesthesia or regional anesthesia [20] [22]. However, no existing literature has reported a nomogram for prolonged PACU LOS of LC patients.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a Nomogram for Determining Patients Requiring Prolonged Postanesthesia Care Unit Length of Stay After Laparoscopic Cholecystectomy

Cao

et al. 2020

Preprint

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Background: Laparoscopic Cholecystectomy (LC) is a common surgical procedure for managing gallbladder disease. Prolonged length of stay (LOS) in the postanesthesia care unit (PACU) may lead to overcrowding and a decline in medical resource utilization. In this work, we aimed to develop and validate a predictive nomogram for identifying patients who require prolonged PACU LOS.Methods: Data from 913 patients undergoing LC at a single institution in China between 2018 and 2019 were collected, and grouped into a training set (cases during 2018) and a test set (cases during 2019). Using the least absolute shrinkage and selection operator regression model, the optimal feature was selected, and multivariable logistic regression analysis was used to build the prolonged PACU LOS risk model. The C-index, calibration plot, and decision curve analysis were used in assessing the model calibration, discrimination, and clinical application value, respectively. For external validation, the test set data was evaluated.Results: The predictive nomogram had 8 predictor variables for prolonged PACU LOS, including age, ASA grade, active smoker, gastrointestinal disease, liver disease, and cardiovascular disease. This model displayed efficient calibration and moderate discrimination with a C-index of 0.662 (95% confidence interval, 0.603 to 0.721) for the training set, and 0.609 (95% confidence interval, 0.549 to 0.669) for the test set. Decision curve analysis demonstrated that the prolonged PACU LOS nomogram was reliable for clinical application when an intervention was decided at the possible threshold of 7%.Conclusions: We developed and validated a predictive nomogram with efficient calibration and moderate discrimination, and can be applied to identify patients most likely to be subjected to prolonged PACU LOS. This novel tool may shun overcrowding in PACU and optimize medical resource utilization.

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“…Predictors for prolonged PACU LOS such as specific anesthesia type, surgical specialty, scheduled surgery duration, postoperative opioid administration, morbid obesity, hypertension, obstructive sleep apnoea have been described in different populations (16)(17)(18)(19)(20)(21)(22). The studies in most cases assessed outpatients (16,21), pediatric populations (17)(18)(19), or all adult surgical patients undergoing general anesthesia or regional anesthesia (20,22). However, no existing literature has reported a nomogram for prolonged PACU LOS of LC patients.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram for determining patients requiring prolonged postanesthesia care unit length of stay after laparoscopic cholecystectomy

Cao¹,

Li²,

Su³

et al. 2021

Ann Palliat Med

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Background: Laparoscopic cholecystectomy (LC) is a common surgical procedure for managing gallbladder disease. Prolonged length of stay (LOS) in the postanesthesia care unit (PACU) may lead to overcrowding and a decline in medical resource utilization. In this work, we aimed to develop and validate a predictive nomogram for identifying patients who require prolonged PACU LOS.Methods: Data from 913 patients undergoing LC at a single institution in China between 2018 and 2019 were collected, and grouped into a training set (456, cases during 2018) and a test set (457, cases during 2019). The definition of PACU LOS is the duration between admission to discharge from PACU, which we can derive from the electronic medical record system. Using the least absolute shrinkage and selection operator regression model, the optimal feature was selected, and multivariable logistic regression analysis was used to build the prolonged PACU LOS risk model. The C-index, calibration plot, and decision curve analysis (DCA) were used in assessing the model calibration, discrimination, and clinical application value, respectively. For external validation, the test set data was evaluated. Results:The predictive nomogram had 8 predictor variables for prolonged PACU LOS, including age, American Society of Anesthesiologists (ASA) grade, active smoker, gastrointestinal disease, liver disease, and cardiovascular disease. This model displayed efficient calibration and moderate discrimination with a C-index of 0.662 (95% confidence interval, 0.603 to 0.721) for the training set, and 0.609 (95% confidence interval, 0.549 to 0.669) for the test set. DCA demonstrated that the prolonged PACU LOS nomogram was reliable for clinical application when an intervention was decided at the possible threshold of 7%. Conclusions:We developed and validated a predictive nomogram with efficient calibration and moderate discrimination, and can be applied to identify patients most likely to be subjected to prolonged PACU LOS. This novel tool may shun overcrowding in PACU and optimize medical resource utilization.

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Is Regional Anesthesia Associated With Reduced PACU Length of Stay?

Cited by 20 publications

References 16 publications

Regional Anesthesia, Time to Hospital Discharge, and In-Hospital Mortality

Regional Anesthesia, Time to Hospital Discharge, and In-Hospital Mortality

Development and Validation of a Nomogram for Determining Patients Requiring Prolonged Postanesthesia Care Unit Length of Stay After Laparoscopic Cholecystectomy

Development and validation of a nomogram for determining patients requiring prolonged postanesthesia care unit length of stay after laparoscopic cholecystectomy

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