Unplanned admissions following outpatient otologic surgery: the University of Arkansas experience

We analyzed the outpatient otologic surgery experience at our institution to identify those factors that are associated with a high risk of postoperative complications that require an unplanned hospital admission. We found that among a group of 662 patients who underwent group II otologic procedures (i.e., tympanoplasty with or without mastoidectomy, stapedotomy, and middle ear exploration), the overall admission rate was 4.7%, of which 3.9% were unplanned. A significantly larger percentage of children were admitted than adults (5.7 vs. 2.3%), primarily for nausea and vomiting. Three factors were significantly associated with unplanned admissions: the type of surgery (tympanomastoidectomy with ossicular reconstruction), the duration of general anesthesia (> 2 hr), and asthma as a coexisting condition. The choice of antiemetic administered (ondansetron or droperidol) and the specific agents used for general anesthesia did not appear to have any significant impact on unplanned admissions. We recommend that the three predisposing factors be taken into consideration when formulating the treatment plan. Scheduling an inpatient procedure for patients who have risk factors for complications requiring hospitalization would avoid the extra costs and stress associated with unplanned admissions.