Unscheduled hospital admission following ambulatory gynecologic surgery.
OBJECTIVE
To identify causes of unscheduled admission following ambulatory gynecologic surgery.


METHODS
We compared each patient admitted on an unscheduled basis with two patients who did not require admission. Thirty demographic and clinical factors were evaluated by univariate analysis. Significant factors (P less than .05) were then analyzed using multivariate stepwise logistic regression.


RESULTS
During a 4-year period, 90 patients required unscheduled admission. This represented 3.64% of 2470 patients who underwent ambulatory gynecologic surgery. Factors associated with admission by multivariate analysis included: 1) previous abdominal surgery, 2) significant medical illnesses, 3) preoperative hemoglobin concentration, 4) general anesthesia, 5) procedure length, and 6) blood loss. Sensitivity was 60.0%, specificity was 90.6%, and the overall correct rate of prediction was 80.4%. Postoperative emesis, the most common reason for unscheduled admissions, occurred in 23.4% of patients.


CONCLUSIONS
Previous abdominal surgery and significant medical illnesses are factors that cannot be altered preoperatively. The need for general anesthesia, procedure length, and blood loss are functions of the procedure and cannot be easily modified. Postoperative emesis may warrant further investigation. Successful antiemetic therapy may reduce unscheduled admissions.
Meeks
G R
GR
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson.
Waller
G A
GA
Meydrech
E F
EF
Flautt
F H
FH
D000556:Ambulatory Surgical Procedures; D016022:Case-Control Studies; D004630:Emergencies; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008922:Mississippi / Q000453:epidemiology; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D014839:Vomiting / Q000453:epidemiology