600 Longer than expected stay in elective general surgical patients - understanding the dynamics
Mohammed Arifuzaman, Sayan Bhattacharya, Ahmed Hammad- Surgery
Abstract
Aims
To find the number of patients listed as elective day case or elective inpatient in general surgical department. To understand the dynamics of the day case surgeries and the predictors of lengthy stay.
Methods
Retrospective analysis of all the elective patients listed in general surgery from December 2021 to May 2022. The age, sex, list number of the patient in the theatre list, surgical time, anaesthetic time and ASA grade were compared against the length of stay. A total of 181 patient studied. Type of surgery listed and reason for longer stay collected from the evolve notes of the patients. Elective surgical patients were included and emergencies excluded. Statistical analysis done on StatsDirect 3.
Results
A total of 181 patients studied and 163 (90 %) were listed as day case (DC) and 18 (10%) as inpatient (IP). Median post-op day (POD) discharge for IP was 1 and DC was 0. Median age for IP was 57.5 years and DC was 49 years. Median surgical time was 85.5 minutes for IP and 72 minutes for DC. Median anaesthetic time was 34.5 minutes for IP and 31 minutes for DC.
Discussions
Overnight observation is the most common reason for the patients to stay in longer seen in 71.4 % patients. Late presentation to ward is the second most common reason, seen in 25 % patients. Median POD discharge for patients with overnight observation and drain is 2. Patients with documented overnight observation + drain + weekend results in POD 4 discharge. Drain – median POD 2 (min 1 max 12). NG – median POD 5 (min 2 max 6).