Unexpected overnight stay following ENT day-case surgery: a 5-year audit

Unexpected overnight stay following ENT day-case surgery: a 5-year audit. Problems/objectives: Recent decades have seen a steady reduction in the average duration of hospitalization for all surgical patients, including those undergoing ENT procedures. Correspondingly, the proportion of day surgeries relative to in-patient surgeries has progressively increased. In the present observational study, we aimed to evaluate the proportion of unplanned overnight stays following planned day surgeries in our ENT unit, and the major causes of these unexpected overnight admissions.

Methods: From databases, we collected data from all patients who underwent ENT day-case surgery in Ziekenhuis OostLimburg between January 2008 and December 2013.

Results: A total of 10,440 patients underwent ENT day-case surgery during this period. The overall rate of unexpected overnight admission was 1.86%, with these overnight admissions most commonly due to anaesthetic (46.91%), surgical (19.59%), and organizational (17.01%) reasons. The types of ENT surgery at the greatest risk for prolonged hospitalisation were hemithyroidectomy (12.50%), tympanoplasty (12.15%), and uvulopalatopharyngoplasty (UPPP) (7.81%). We further identified a clear difference in the rate of unexpected overnight stay between surgery scheduled in the morning (1.17%) versus in the afternoon (12.98%).

Conclusions: Our present findings highlight the various reasons for unexpected overnight admission after day-case surgery. To reduce the rate of unexpected overnight stays, we need to better understand these different reasons to support the ongoing search for possible solutions.