Evidence Based Practice and Quality Assurance
Background and Goal of Study: The systematic collection and analysis of incidents is essential for risk management, but consequences of intraoperative events are often difficult to assess. Do they influence Post Anesthesia Care Unit (PACU) length of stay (LoS)?
Materials and Methods: From 01/2000 to 04/2004, every anesthesia is described with the patient features, the anesthetic technique and the occurrence of events (out of a list of 58), using a preformatted sheet then recorded in a data base. An univariate, then multivariate analysis were performed to assess associations between the occurrence of an intraoperative event and PACU LoS in Quartile (Q), taking into account age (Q), ASA physical status, surgery duration (Q), transfusion need, anesthetic technique.
Results and Discussions: All the anesthesia procedures have been analyzed (n = 19118). 22% are associated with incidents. PACU LoS is respectively 141 ± 100 min and 102 ± 110 min according to the occurrence of an incident or not (p < 0.05). As expected, patients who experience an intraoperative incident are older (53 ± 37 vs 46 ± 23) and suffer from a worse condition (ASA status) (p < 0.05). Odds ratio (OR) of associated factors are:
Reference group (OR = 1) is not displayed. The occurrence of an intraoperative incident is associated with an increase in PACU LoS, independently of age, ASA status, surgery duration, transfusion need and anesthetic technique.
Conclusion: The occurrence of an intraoperative incident is a predictive indicator of PACU stay lengthening that could be considered for PACU management.