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Evaluation of the pediatric post anesthesia discharge scoring system in an ambulatory surgery unit
Jean Benoit Moncel1, Nicolas Nardi, Eric Wodey
1Service d'Anesthésie Réanimation Chirurgicale 2, CHU Hôpital Sud, Rennes, France.
Insights
The pediatric postanesthetic discharge scoring system (Ped-PADSS) safely and efficiently facilitates same-day surgery discharge for children. This validated tool significantly reduces hospital stay, optimizing pediatric ambulatory care.
Area of Science:
- Pediatric Anesthesiology
- Ambulatory Surgery
- Patient Discharge Criteria
Background:
- Optimizing care pathways for pediatric ambulatory surgery is crucial.
- A pediatric postanesthetic discharge scoring system (Ped-PADSS) was adapted from adult protocols.
- The study aimed to prospectively evaluate the Ped-PADSS in children undergoing day surgery.
Purpose of the Study:
- To assess the efficacy of the Ped-PADSS in a pediatric day surgery cohort.
- To determine the time to discharge eligibility using the Ped-PADSS.
- To compare postoperative hospital stay duration before and after Ped-PADSS implementation.
Main Methods:
- Prospective observational study at a single center.
- Inclusion of children aged 6 months to 16 years undergoing day surgery.
- Discharge validation using Ped-PADSS scores (≥9) at hourly intervals post-anesthesia, with surgeon agreement.
Main Results:
- 1060 children were included in the study.
- 97.2% of children were eligible for discharge 1 hour post-anesthesia care unit (PACU) return.
- 99.8% were eligible by 2 hours post-PACU return.
- Median postoperative hospital stay was reduced by 69 minutes (P < 0.01).
Conclusions:
- The Ped-PADSS enables timely discharge for most children within 1 hour of PACU return.
- Discharge using Ped-PADSS ensures children go home in safe and optimal condition.
- The score effectively optimizes the pediatric ambulatory surgery care pathway.
Introduction:
To optimize the care pathway for children scheduled for ambulatory surgery, a pediatric postanesthetic discharge scoring system (Ped-PADSS) was developed from a score used in adults. The objective of this study was to evaluate this score prospectively on a cohort of children who had a day case surgical procedure.
Materials And Methods:
This was a single center prospective observational study. Inclusion criteria were predefined as follows: children aged 6 months-16 years at the time of the study, with a scheduled day surgery. Discharge was validated by Ped-PADSS scores ≥9, obtained at one hour intervals, after the return from the operating room and with the agreement of the surgeon. The duration of postoperative hospitalization was compared with data collected before the implementation of the score using the Student's t-test.
Results:
From February to July 2012, 1060 children were included. One hour after the return from the operating room, 97.2% of children were dischargeable using Ped-PADSS. Two hours after the return from the operating room, 99.8% of children were dischargeable. The median postoperative hospital stay (n = 1041) was reduced by 69 min compared to the median stay before using the output score (n = 150) (P < 0.01).
Conclusion:
The Ped-PADSS score allows for the majority of children to be discharged 1 h after their return from the postanesthesia care unit. Children who were discharged using the Ped-PADSS score returned home in safe and optimal conditions.
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