# Unplanned Admission Following Day Surgery: A Retrospective Analysis of Rates, Causes, and Associated Risk Factors at a Single Center

## TL;DR

This study analyzed why some day surgery patients needed to stay in the hospital, finding that 7.6% required unplanned admission, often due to the need for further observation.

## Contribution

The study identifies risk factors and causes for unplanned admission after day surgery at a specific hospital in Saudi Arabia.

## Key findings

- Laparoscopic cholecystectomy had the highest conversion rate to inpatient care at 18.3%.
- General anesthesia was associated with higher rates of unplanned admission.
- Women undergoing cholecystectomy had a higher conversion rate than men.

## Abstract

Background

Day surgery, also known as same-day surgery, involves admitting and discharging patients on the same day, aiming to reduce hospital stays. However, various factors can necessitate unplanned inpatient admission.

This study assessed admission rates following day surgery and evaluated the causes and associated risk factors, including patient characteristics, type of anesthesia, type of surgery, and time of arrival at the day surgery unit, at Buraidah Central Hospital, Qassim, Saudi Arabia.

Methods

A retrospective cohort study was conducted in Buraidah Central Hospital, Qassim, Saudi Arabia, using medical records of patients who underwent day surgery between January 2022 and December 2023. Data on demographics, cause of admission, comorbidities, surgery type, anesthesia, and arrival time at the day surgery unit were analyzed.

Results

Of 3,806 patients who underwent day surgery during the study period, 293 (7.6%) were converted to inpatient care. Most admitted patients were aged 18-59 years, men, and overweight. The primary reasons for admission were the need for further observation and close monitoring. Laparoscopic cholecystectomy was the most common procedure, followed by adenotonsillectomy. Women undergoing laparoscopic cholecystectomy had a higher conversion rate than men. Adenotonsillectomy was more common among patients admitted due to complications.

Conclusion

The conversion rate from day surgery to inpatient care was 7.6%, higher than the rates reported in other hospitals. This may be linked to the high prevalence of laparoscopic cholecystectomy, which had an 18.3% local conversion rate. General anesthesia was associated with higher conversion rates. No intensive care unit (ICU) admissions were recorded, suggesting severe complications were rare despite the conversions.