Seago J A, Weitz S, Walczak S
Department of Community Health Systems, University of California, San Francisco 94143-0608, USA.
J Clin Anesth. 1998 Nov;10(7):579-87. doi: 10.1016/s0952-8180(98)00084-1.
To identify indicators of prolonged length of stay (LOS) in the postanesthesia care unit (PACU) and to test the following hypotheses: (1) that patient age, pain medication administration at the time of PACU admission, length of surgery, and cardiovascular, pulmonary, and pain responses postoperatively predict prolonged PACU LOS and (2) that cardiovascular and pulmonary symptoms preoperatively predict cardiovascular and pulmonary symptoms postoperatively.
Prospective, observational analysis.
PACU of a university teaching hospital.
1,067 patients scheduled for surgery with general anesthesia between February and September 1996, 18 years of age or older.
11.2% of the variation in prolonged PACU LOS can be predicted by age, pain medication at the time of PACU admission, and postoperative cardiovascular, pulmonary, and pain symptoms. A significant number of patients who did not report a prior history experienced postoperative cardiovascular and pulmonary symptoms.
Patient history and postoperative symptoms predict only a small percentage of prolonged PACU stays. Organizational factors may be a more important predictor of prolonged PACU stay. Additionally, assessment of cardiovascular and pulmonary history needs refinement to improve prediction of patient responses postoperatively.
确定麻醉后护理单元（PACU）中住院时间延长的指标，并检验以下假设：（1）患者年龄、PACU入院时的止痛药物使用情况、手术时长以及术后心血管、肺部和疼痛反应可预测PACU住院时间延长；（2）术前心血管和肺部症状可预测术后心血管和肺部症状。
前瞻性观察分析。
一所大学教学医院的PACU。
1996年2月至9月期间计划接受全身麻醉手术的1067例患者，年龄18岁及以上。
PACU住院时间延长的差异中有11.2%可通过年龄、PACU入院时的止痛药物使用情况以及术后心血管、肺部和疼痛症状来预测。大量既往无相关病史的患者出现了术后心血管和肺部症状。
患者病史和术后症状仅能预测一小部分PACU住院时间延长的情况。组织因素可能是PACU住院时间延长更重要的预测因素。此外，需要完善对心血管和肺部病史的评估，以改善对患者术后反应的预测。
