Predictors of unexpected hospital admissions after outpatient endoscopic sinus surgery: retrospective review

• Published in: Journal of otolaryngology-head and neck surgery Vol. 37; no. 3; p. 309
• Main Authors: Lin, Denny, Dalgorf, Dustin, Witterick, Ian J
• Format: Journal Article
• Language: English
• Published: England 01.06.2008
• Subjects: Ambulatory Surgical Procedures; Endoscopy - methods; Female; Humans; Incidence; Male; Ontario - epidemiology; Paranasal Sinus Diseases - surgery; Patient Admission - statistics & numerical data; Postoperative Complications - epidemiology; Retrospective Studies; Risk Factors; Ontario
• ISSN: 1916-0216
• DOI: 10.2310/7070.2008.0061

Endoscopic sinus surgery (ESS) is typically performed on an outpatient basis in our centre. The purpose of this study is to determine the frequency of unexpected stays in patients who undergo ESS. This information would be useful to identify and to counsel these potential patients. Retrospective chart review of 194 consecutive patients who had ESS during a 6-month span. Multivariate analysis was performed on 11 variables identified in the charts to determine whether any of the data predicted an unexpected admission. The unexpected rate of admission was 4.7%. Surgical complications causing admission occurred in 1% of the cases. Reasons for admissions included nausea and vomiting, hypotension, oxygen desaturation, headache, postoperative epistaxis, and observation for possible cerebrospinal fluid leak. None of the 11 variables that were examined showed statistical significance as independent predictors of unexpected admissions. However, two variables, the presence of comorbidities and the use of ondansetron, did approach statistical significance. Unexpected admissions following ESS are infrequent, and the reasons for admission are varied. In this study, although 9 of the 11 parameters evaluated showed no statistical significance as independent predictors of unexpected admissions, 2 did approach statistical significance. Intuitively, the presence of patient comorbidities would be expected to place the patient at greater risk of unexpected admission. Ondansetron is a potent antiemetic and is reserved for patients at risk or in those having severe symptoms. These patients would also be expected to have an increased risk of an unanticipated hospital stay.