Hospital admissions from the Surgical Day Care Centre of Vancouver General Hospital 1977–1987

  • Peter F. Fancourt-Smith
  • Jeffrey Hornstein
  • Leonard C. Jenkins
Occasional Survey

Abstract

The admissions to Vancouver General Hospital from its Surgical Day Care Centre were reviewed for the period I977 to 1987. The overall mean rate of admission for the period was 0.28 per cent, for surgically-related admissions 0.22 per cent and for anaesthesia-related admissions 0.07 per cent. The principal reasons for surgery-related admissions were postoperative bleeding, complications, the need for further surgery, the requirement for prolonged postoperative care, and pain. Urology had a particularly high percentage of admissions compared with its workload, because of the diagnostic nature of much of the work. Anaesthesia-related admissions included “syncope,” lack of an accompanying adult, aspiration pneumonitis and coincident acute disease. Twelve of the 14 patients admitted with syncope had surgery in the afternoon and had received less than ideal amounts of intravenous fluid. Seven of the 12 ASA physical status 11 patients admitted had an admission diagnosis related to the coincident disease.

Key words

Anaesthesia: out-patient, complications 

Résumé

Les admissions d’un jour du Centre de chirurgie de l’Hôpital Général de Vancouver ont été revues pour la période de 1977 à 1987. Le taux moyen général d’admission pour cette période était de 0,28 pour cent et de 0,22 pour cent pour les admissions chirurgicales et 0,07 pour cent pour les admissions aneslhésiques. Les raisons principals pour les admissions chirurgicales étaient le saignement postopératoire ou d’autres complications, la nécessté d’une chirurgie plus extensive, la nécessité de soins postopératoires prolongés et la douleur. L’urologie présentait un pourcentage particulièrement élevé d’admission comparativement à sa charge de travail principalement à cause de la nature diagnostique de la plupart des procédures. Les admissions reliées à l’anesthésie incluent «la syncope», l’absence d’escorte adulte, la pneumonie d’aspiration et l’existence concomitante d’une maladie aiguë. Douze des 14 patients admis pour syncope ont été opérés l’après-midi et ont reçu une quantit/’e insuffisante de liquide intraveineux. Sept des 12 patients admis ayant un état physique ASA 11 présentment une maladie concomitante.

References

  1. 1.
    Levy M-L. Complications: prevention and quality assurance.In: Out Patient Anesthesia. Anesthesiology Clinics of North America 5:1, Mar 1987. Levy M-L, Weintraub HD (Eds.). Philadelphia: W.B. Saunders.Google Scholar
  2. 2.
    Wetchler BV. Post operative management, discharge and follow-up.In: Out Patient Anesthesia. Anesthesiology Clinics of North America 5:1, Mar 1987. Levy M-L, Weintraub HD (Eds.), Philadelphia: W.B. Saunders.Google Scholar
  3. 3.
    Paasuke RT, Davies JM. Anaesthesia for daycare patients: controversies and concerns. Can Anaesth Soc J 1986; 33: 5: 644–6.CrossRefGoogle Scholar
  4. 4.
    Patterson FJ, Bechtoldt AA, Levin KJ. Ambulatory surgery in a university setting. JAMA 1976; 235: 266–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Natof HE. Complications.In: Wetchler BV (Ed.). Anesthesia for Ambulatory Surgery. Philadelphia: J.B. Lippincott 1985.Google Scholar
  6. 6.
    Kallar SK. Aspiration pneumonitis: fact or fiction?In: Out Patient Anesthesia. Problems in Anesthesia 2:1, January–March 1988. Wetchler BV (Ed.). Philadelphia, J.B. Lippincott.Google Scholar
  7. 7.
    Natof HE. Special Study I. Alexandria VA 1987. Federated Ambulatory Surgery Association.Google Scholar

Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Peter F. Fancourt-Smith
    • 1
  • Jeffrey Hornstein
    • 1
  • Leonard C. Jenkins
    • 1
  1. 1.Department of Anaesthesia, Faculty of MedicineThe University of British Columbia, Vancouver General HospitalVancouver

Personalised recommendations