Which patients are more likely to need an unexpected hospital stay after outpatient ear surgery?

Details

Researchers analyzed outpatient otologic surgery experience at their institution to identify factors associated with a high risk of postoperative complications requiring an unplanned hospital admission. This was a single-institution analysis; the abstract does not specify whether data collection was retrospective or prospective.

The analysis included 662 patients who underwent group II otologic procedures: tympanoplasty with or without mastoidectomy, stapedotomy, and middle ear exploration. The overall hospital admission rate was 4.7%, with unplanned admissions reported at 3.9%.

A significantly larger percentage of children were admitted than adults: 5.7% versus 2.3%. These admissions were primarily for nausea and vomiting.

Three factors were significantly associated with unplanned admissions: the type of surgery—tympanomastoidectomy with ossicular reconstruction—general anesthesia lasting more than 2 hours, and asthma as a coexisting condition.

The choice of antiemetic, ondansetron or droperidol, and the specific agents used for general anesthesia did not appear to have any significant impact on unplanned admissions.

The researchers recommend considering the three predisposing factors when formulating a treatment plan.

They conclude that scheduling an inpatient procedure for patients with risk factors for complications requiring hospitalization would avoid the extra costs and stress associated with unplanned admissions.