Unanticipated admissions following 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.…”

“…Admission after haemorrhoidectomy was commonly reported to be more than 10% and bleeding was the commonest cause. 12,20 However, the commonest reason in the present report was the use of spinal anaesthesia leading to urinary retention. Urinary retention causing admission after spinal anaesthesia for day surgery is common.…”

“…Hypertension, dysrrhythmia, pulmonary problems, hyperglycaemia and cerebrovascular accident have been reported. 12,19 The absence of these in the present series might again be a result of the restriction of day case surgery to the fittest patients. 11,14 Non-clinical causes, including inappropriate social condition of the patient and late starting of operation, precipitated a significant number of admissions.…”

“…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.…”