"When Can i Go Home?"-Unplanned Admissions following day case elective surgery

ABSTRACT

Aim: Day case surgeryisan effective and economical method tomanage patients while maintaining quality of care. During The COVID-19 pandemic and The reinstatement of non-cancerous elective surgery, efficient use of bed space capacity has been crucial. Strategies were implemented to reduce unplanned admission rates, including careful patient selection and preoperative assessment. We aimed to review rates of unplanned admissions (UA) following intended day case procedures and to identify methods of future prevention of UA. Method(s) A retrospective review was carried out of patients undergoing day case hernia repairs or laparoscopic cholecystectomy in a single district General hospital, between May 2021 and September 2021. Data was collated from an institutional data base with follow up data obtained from an electronic care record. Result(s)53patientsincluded,withamedianageof76years (range23-79), 56.6% male, 23 inguinal hernia repairs and 30 cholecystectomies. 30.2% were unexpectedly admitted post operatively (9 Cholecystectomies and 7 inguinal hernias). Of those admitted, median length of stay was 3.1 days (range2-10). Reason for admission included pain (43.8%), postoperative complications (18.8%) and urinary retention (18.8%). Patients requiring admission were significantly older (mean age 62 vs 49 years old), were more likely to be male (62.5% vs 37.5%) and had a significantly longer theatre time (1.46 vs 1.08 hours, p=0.0001). Conclusion(s) Our short review has identified older and male patient are more likely to require an overnight admission. Improvement in pain management, theatre planning and streamlining along with optimal discharge planning may reduce The volume of patient requiring UA.