Key result
Introduction of a post-anaesthesia care unit for intermediate to high-risk noncardiac surgery was associated with a decreased hospital length of stay (GMR 0.77; 95% CI 0.66-0.91; p=0.002).
Why the study?
A PACU may improve postoperative care compared with intermediate care units due to dedicated operative care and individualized stays, but its effects after intermediate to high-risk noncardiac surgery were unclear.
Does admission to a post-anaesthesia care unit (PACU) reduce hospital length of stay compared to an intermediate care unit (IMCU) in patients undergoing intermediate to high-risk noncardiac surgery?
Observational (n=3,300)
No
Does admission to a post-anaesthesia care unit (PACU) reduce hospital length of stay compared to an intermediate care unit (IMCU) in patients undergoing intermediate to high-risk noncardiac surgery?
Effect estimate: GMR 0.77 (95% CI 0.66-0.91)
Absolute Event Rate: 6% vs 7.2%
p-value: p=0.002
The transition from an intermediate care unit to a post-anaesthesia care unit for postoperative care in noncardiac surgery is associated with a reduced hospital length of stay without increasing complications.
PACU transition was associated with shorter stays without more complications; leaves open need for multicenter confirmation before practice change.
Background: A post-anaesthesia care unit (PACU) may improve postoperative care compared with intermediate care units (IMCU) due to its dedication to operative care and an individualized duration of postoperative stay. The effects of transition from IMCU to PACU for postoperative care following intermediate to high-risk noncardiac surgery on length of hospital stay, intensive care unit (ICU) utilization, and postoperative complications were investigated. Methods: This single-centre interrupted time series analysis included patients undergoing eleven different noncardiac surgical procedures associated with frequent postoperative admissions to an IMCU or PACU between January 2018 and March 2019 (IMCU episode) and between October 2019 and December 2020 (PACU episode). Primary outcome was hospital length of stay, secondary outcomes included postoperative complications and ICU admissions. Results: In total, 3300 patients were included. The hospital length of stay was lower following PACU admission compared to IMCU admission (IMCU 7.2 days [4.2–12.0] vs. PACU 6.0 days [3.6–9.1]; p < 0.001). Segmented regression analysis demonstrated that the introduction of the PACU was associated with a decrease in hospital length of stay (GMR 0.77 [95% CI 0.66–0.91]; p = 0.002). No differences between episodes were detected in the number of postoperative complications or postoperative ICU admissions. Conclusions: The introduction of a PACU for postoperative care of patients undergoing intermediate to high-risk noncardiac surgery was associated with a reduction in the length of stay at the hospital, without increasing postoperative complications.
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Koning et al. (2024) conducted an observational in Intermediate to high-risk noncardiac surgery (n=3,300). Post-anaesthesia care unit (PACU) vs. Intermediate care unit (IMCU) was evaluated on Hospital length of stay (GMR 0.77, 95% CI 0.66-0.91, p=0.002). Introduction of a post-anaesthesia care unit for intermediate to high-risk noncardiac surgery was associated with a decreased hospital length of stay (GMR 0.77; 95% CI 0.66-0.91; p=0.002).
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