背景:麻醉后监护病房(PACU)在为术后患者提供专门护理方面起着至关重要的作用。然而,其中一部分患者出现并发症,导致在PACU中的停留时间延长90分钟或更长时间.这不仅影响患者的生活质量,而且扰乱医院的工作流程,因为它可能会导致术后疼痛,恶心,或呕吐。必须确定导致这种长期住院(LOS)的因素,并探索其预防和管理策略。方法:我们对2020年至2021年的术后患者进行了回顾性队列研究。我们包括了长期住院的病人,不包括心脏病患者,计划长期住院的患者,和等待重症监护室病床的病人.我们使用了非概率连续采样技术。数据来自BestCare系统,医院的信息系统,使用数据收集表。
结果:在研究期间共有15,170名患者接受了外科手术,其中只有181人(1.19%)经历了长时间的PACU逗留。疼痛和精神状态改变与PACU停留时间延长密切相关(分别为P=0.035和P=0.0009)。然而,在PACU中,总体合并症与延长的LOS之间没有显着关联,哮喘患者除外(P=0.003)。不同类型和持续时间的手术对延长PACU的停留时间没有显着贡献。
结论:我们的研究发现,在所检查的各种变量中,哮喘,疼痛,精神状态改变与PACU中LOS延长显著相关。这些结果表明,针对这些因素的针对性干预措施可能有助于减少PACU住院时间延长的发生率并优化患者预后。
BACKGROUND: The post-anesthesia care unit (PACU) plays a crucial role in providing specialized care to postoperative patients. However, a subset of these patients experiences complications that result in a prolonged stay of 90 minutes or more in the PACU. This not only impacts the patient\'s quality of life but also disrupts hospital workflow, as it might cause postoperative pain, nausea, or vomiting. It is essential to identify the factors contributing to this prolonged length of stay (LOS) and explore strategies for its prevention and management. Methods: We conducted a retrospective cohort study of postoperative patients between 2020 and 2021. We included patients who had a prolonged stay, excluding cardiac patients, patients who had a planned prolonged stay, and patients waiting for an intensive care unit bed. We used a non-probability consecutive sampling technique. Data were obtained from the BestCare System, the hospital\'s information system, using a data collection sheet.
RESULTS: A total of 15,170 patients underwent surgical procedures during the study period, out of which only 181 (1.19%) experienced a prolonged PACU stay. Pain and altered mental status were strongly associated with a prolonged PACU stay (P = 0.035 and P = 0.0009, respectively). However, there was no significant association between overall comorbidities and prolonged LOS in the PACU, except for patients with asthma (P = 0.003). Different types and durations of surgeries did not significantly contribute to a prolonged PACU stay.
CONCLUSIONS: Our study found that among the various variables examined, asthma, pain, and altered mental status were significantly associated with a prolonged LOS in the PACU. These findings suggest that targeted interventions addressing these factors may help reduce the incidence of prolonged PACU stays and optimize patient outcomes.