Whippey et al identified risk factors for unanticipated hospital admission following ambulatory surgery. These can help to identify a patient who may have an unanticipated complication during or after the procedure. The authors are from McMaster University and St. Joseph's Healthcare in Hamilton, Ontario.


Patient selection: ambulatory surgery and unanticipated hospital admission


Risk factors for unanticipated admission:

(1) surgery duration > 1 hour

(2) body mass index (BMI) 30 to 35 kg per square meter

(3) age > 80 years

(4) ASA class III or higher (the number of ASA V should be very small)

(5) general surgery


Factors associated with a lower rate of unanticipated admissions:

(1) current smoker

(2) low-risk procedures (plastic, orthopedic, ENT)

(3) monitored anesthesia care (vs general anesthesia or regional)


When looking at the risk the key is "unanticipated." A smoker or obese patient is more likely to have an anticipated admission following ambulatory surgery.


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