Factors influencing stay in the postanesthesia care unit: A prospective analysis

Study Objective: To identify indicators of prolonged length of star (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. Design: Prospective, observational analysis. Setting: PACU of a university teaching hospital. Patients: 1,067 patients scheduled for surgery with general anesthesia between February and September 1996, 18 rears of age or older. Measurement and Main Results: 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. Conclusion: 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. (C) 1998 by Elsevier Science Inc.