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Overstay And Readmission In Ear, Nose, And Throat Day Surgery—Factors Affecting Postanesthesia Course

Morag Tolvi, Lasse Lehtonen, Hanna Tuominen-Salo, Mika Paavola, Kimmo Mattila, Leena-Maija Aaltonen

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Aims: Many procedures in ear, nose, and throat (ENT) day surgery are carried out under local anesthesia in Finland, whereas many other countries use general anesthesia. We investigated overstay and readmission rates in local and general anesthesia at Helsinki University Hospital. Material and Methods: We conducted a retrospective study on ENT (n = 1011) day surgery patients within a 3-month period using the hospital’s surgery database to collect data pertaining to anesthesia, overstays, readmissions, and contacts within 30 days of surgery. Objectives: We examined the effect of American Society of Anesthesiologists (ASA) class, age, sex, type of procedure, and anesthesia type on overstay, contact, and readmission rates. Results: A multivariable logistic regression model included ASA class, age, sex, type of procedure, and anesthesia (local vs general). Sex, age, and type of procedure had an effect on the outcomes of overstay, readmission, or contact. With general anesthesia, 3.2% (n = 23) had an overstay or readmission compared to 1.4% (n = 4) after local anesthesia. This was mainly explained by the number of study outcomes in tonsillar surgery that was performed only in general anesthesia. Conclusions: Day surgery could be done safely using local anesthesia, as the number of study outcomes was no greater than in general anesthesia. Sex, type of procedure, and age affected the rate of study outcomes, but ASA class and anesthesia form did not. Our overstay, contact, and readmission rates are on the same level, or lower, than in international studies.