Pediatric Unplanned Admission in Specialized Tertiary Children Hospital; Case-control study.: Pediatric Unplanned Admission in Specialized Tertiary Children Hospital

Mohamed Daabiss; Ahmed H.  Mahran; Nezar  Al Zughaibi; Abdulhameed F.  Basaleem; Khaled  AlManea; Mohamed I.  Emam; Ahmed H.  Mahmoud

doi:10.54293/smhj.v5i1.109

Authors

Mohamed Daabiss Consultant Anesthesia, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. https://orcid.org/0009-0005-4226-763X
Ahmed H. Mahran Department of Pediatric Anesthesia King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia. https://orcid.org/0000-0002-5910-4803
Nezar Al Zughaibi Department of Pediatric Anesthesia King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.
Abdulhameed F. Basaleem Department of Pediatric Anesthesia King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.
Khaled AlManea Department of Pediatric Anesthesia King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.
Mohamed I. Emam Department of Pediatric Anesthesia King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia. https://orcid.org/0009-0005-2470-5755
Ahmed H. Mahmoud Department of Pediatric Anesthesia King Abdullah Specialized Children Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia. https://orcid.org/0000-0003-3010-5930

DOI:

https://doi.org/10.54293/smhj.v5i1.109

Keywords:

Pediatric, Unplanned Admission, anesthesia, pediatric surgery, Tertiary Hospital, control study.

Abstract

Background: Unplanned hospital admissions following surgical procedures are an important quality performance indicator, as they can reflect complications from anesthesia or surgery, in addition to communication issues within the healthcare team. Any patient who undergoes a surgical procedure under general anesthesia but has an unexpected hospital disposition, differing from the pre-operative plan, is considered to have an unplanned admission. These unanticipated admissions can have negative social, economic, and physical consequences for these patients. This study aimed to determine the proportion of unplanned post-operative admissions and to investigate the risk factors that contributed to these unplanned admissions.

Methods: The data on unplanned admissions was collected retrospectively by analyzing the medical records of children aged 14 and younger who underwent non-cardiac surgical procedures under general anesthesia at the King Abdullah Specialized Children's Hospital (KASCH) facility from January 2021 to October 2022.

Results: Out of 15,178 non-cardiac procedures performed, 119 patients (0.78%) experienced unplanned admission. The leading contributing factors were anesthesia-related in 49 patients (41.2%), surgical-related factors in 35 patients (29.4%), and communication failure between the anesthesia, surgical teams, and bed management in 19 cases (16%).

Conclusion: The unplanned admission rate of 0.78% in this facility was lower than the rates reported in the literature. However, these rates may not represent the national practice, and more multi-center studies are needed to gain a more comprehensive understanding of the extent of this problem within the country.