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:
(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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