Gold B S, Kitz D S, Lecky J H, Neuhaus J M
Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia.
JAMA. 1989 Dec 1;262(21):3008-10.
We conducted a case-control study to identify clinical and demographic risk factors for admission to the hospital following ambulatory surgery. Of 9616 adult patients who underwent ambulatory surgery at a university-affiliated hospital between 1984 and 1986, one hundred were admitted. The most common reasons for admission were pain (18), excessive bleeding (18), and intractable vomiting (17). The mean age (+/- SD) of patients who were admitted was 37 +/- 13 years, and 96% had American Society of Anesthesiologists' physical status scores of 1 or 2. Factors that were independently associated with an increased likelihood of admission were general anesthesia (odds ratio, 5.2), postoperative emesis (odds ratio, 3.0), lower abdominal and urologic surgery (odds ratio, 2.9), time in the operating room greater than 1 hour (odds ratio, 2.7), and age (odds ratio, 2.6). Our results indicate that the likelihood of unanticipated admission is related more to the type of anesthesia and surgical procedure rather than to the patient's clinical characteristics.
我们开展了一项病例对照研究，以确定门诊手术后入院的临床和人口统计学风险因素。在1984年至1986年间于一家大学附属医院接受门诊手术的9616例成年患者中，有100例入院。入院的最常见原因是疼痛（18例）、出血过多（18例）和顽固性呕吐（17例）。入院患者的平均年龄（±标准差）为37±13岁，96%的患者美国麻醉医师协会身体状况评分为1或2。与入院可能性增加独立相关的因素包括全身麻醉（比值比，5.2）、术后呕吐（比值比，3.0）、下腹部和泌尿外科手术（比值比，2.9）、手术时间超过1小时（比值比，2.7）以及年龄（比值比，2.6）。我们的结果表明，意外入院的可能性更多地与麻醉类型和手术操作有关，而非患者的临床特征。
