Factors related to delayed discharge of general anesthesia patients from the Post Anesthesia Care Unit (PACU) in Huaiyot hospital, Trang province

Abstract

The immediate postoperative patient care within the Post Anesthesia Care Unit (PACU) is critical due to post-operative patients have a high risk of complications. Several factors contribute to prolonged PACU stays, which can impact the surgical team, especially in facilities with limited operating and recovery rooms. This study aimed to identify factors associated with delayed patient discharge from the PACU and develop guidelines for optimizing anesthesia patient care systems. The research was a
retrospective study design. The sample consisted of 801 patients who underwent general anesthesia at Huaiyot hospital, Trang province, from October 2021 to September 2022. Data were collected by data record form including patient demographics, surgical details, and anesthetic information. Descriptive statistics were used to analyze patient characteristics, while factors associated with delayed discharge from PACU were identified using odds ratios (ORs), 95% CI, and multivariate binary logistic regression analysis.

The study found an incidence of 13.9% of patients experienced delayed discharge from the PACU. Six factors were associated with delayed discharge with four being risk factors including orthopedic surgery of both upper and lower extremities (Adj. OR=12.20, 95% CI=1.15-130.04, p=0.038), general anesthesia duration equal to 3 hours or more (Adj. OR=5.39, 95% CI=2.07-13.99, p=0.001), post-operative cardiovascular complications (Adj. OR=4.25, 95% CI=1.48-12.18, p=0.007), and female gender (Adj. OR=2.00, 95% CI=1.18-3.41, p=0.011). However, two factors were associated with reduced risk of delayed discharge that were minor gynecological surgery (Adj. OR=0.08, 95% CI=0.02-0.37, p=0.001) and gastrointestinal endoscopy (Adj. OR=0.09, 95% CI=0.02-0.50, p=0.006).

In conclusion, most of the associated factors contributing to delayed discharge from the PACU were beyond direct control. Therefore, the study results should be used to develop PACU anesthesia practice guidelines that should emphasize risk stratification, preventative measures, and complication management protocols to prioritize patient safety and efficient discharge in the specified time frame.