Predictors of Delayed Recovery in Ambulatory Advanced Endoscopic Procedures

There is a scarcity of data evaluating patient-related outcomes of advanced or complex endoscopy (ACE) through the post-anesthesia recovery course. Yet, gastrointestinal distress following ACE can occur commonly, and this may impact recovery length of stay and the approach to post-anesthesia care. This study aimed to describe post-procedural symptoms in patients undergoing ACE and identify factors that influence recovery time and course.

We retrospectively reviewed a prospectively collected database of patients who underwent ambulatory ACE. Procedural-related symptoms, recovery time, dismissal rate, and adverse events (AE) were recorded. Factors associated with extended recovery time were analyzed using multiple regression analysis. Secondary outcomes included unplanned hospitalization rate and AEs.

A total of 172 patients were included, with a mean age of 62.77 years (standard deviation 14.176). 64 patients (37.2%) had an extended recovery time. Abdominal pain and nausea were the most common symptoms associated with extended recovery. Female sex, longer procedure duration, and higher post-procedural pain scores at 30 min were significantly associated with extended recovery (p < 0.05). The procedural-related AE rate was 5.8%, and the overall unplanned hospitalization rate was 3.5%.

Procedural-related symptoms following ACE are common, and female sex, duration of procedure, and post-procedural pain score at 30 min are predictive of length of stay. These data provide insight into optimizing the approach to post-procedure care in ACE.