ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2023
Development and validation of an instrument to predict prolonged length of stay in the postanesthesia care unit following ambulatory surgery.
Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 7 citations in OpenAlex.
- Healthcare-Based Multimodal Recovery Prediction for the Warfighter: A Retrospective Study.Military medicine · 2026Article
- Over-night monitoring in intensive care unit and short-term monitoring in post anesthesia care unit costs analysis after elective hepato-pancreatic-biliary surgery: a retrospective study.Updates in surgery · 2026Article
- Comparative study of ambulatory versus inpatient laparoscopic cholecystectomy in Thailand: Assessing effectiveness and safety with a propensity score matched analysis.Annals of hepato-biliary-pancreatic surgery · 2024Article
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Authors and funding
13 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe sought to develop and validate an Anticipated Surveillance Requirement Prediction Instrument (ASRI) for prediction of prolonged postanesthesia care unit length of stay (PACU-LOS, more than four hours) after ambulatory surgery.
methodsWe analyzed hospital registry data from patients who received anesthesia care in ambulatory surgery centres (ASCs) of university-affiliated hospital networks in New York, USA (development and internal validation cohort [n = 183,711]) and Massachusetts, USA (validation cohort [n = 148,105]). We used stepwise backwards elimination to create ASRI.
resultsThe model showed discriminatory ability in the development, internal, and external validation cohorts with areas under the receiver operating characteristic curve of 0.82 (95% confidence interval [CI], 0.82 to 0.83), 0.82 (95% CI, 0.81 to 0.83), and 0.80 (95% CI, 0.79 to 0.80), respectively. In cases started in the afternoon, ASRI scores ≥ 43 had a total predicted risk for PACU stay past 8 p.m. of 32% (95% CI, 31.1 to 33.3) vs 8% (95% CI, 7.9 to 8.5) compared with low score values (P-for-interaction < 0.001), which translated to a higher direct PACU cost of care of USD 207 (95% CI, 194 to 2,019; model estimate, 1.68; 95% CI, 1.64 to 1.73; P < 0.001) The effects of using the ASRI score on PACU use efficiency were greater in a free-standing ASC with no limitations on PACU bed availability.
conclusionWe developed and validated a preoperative prediction tool for prolonged PACU-LOS after ambulatory surgery that can be used to guide scheduling in ambulatory surgery to optimize PACU use during normal work hours, particularly in settings without limitation of PACU bed availability.
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