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Predictors of Unplanned Admission After Outpatient Rhytidectomy
Angela Alnemri1, Neha Garg1, Dana Michlin2
1Facial plastic and reconstructive surgeons, Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
Aesthetic Surgery Journal
|June 20, 2026
Summary
Identifying predictors of unplanned admission after rhytidectomy is crucial for same-day discharge success. Longer anesthesia, more procedures, obesity, and certain anesthetics increase admission risk, impacting patient safety and hospital resources.
Area of Science:
- Plastic Surgery
- Anesthesiology
- Health Services Research
Background:
- Rhytidectomy (facelift surgery) is increasingly performed in outpatient settings aiming for same-day discharge.
- A significant number of patients require unplanned hospital admission post-procedure, increasing costs and disrupting hospital workflows.
- Identifying predictors of unplanned admission is essential for optimizing perioperative planning and patient management.
Purpose of the Study:
- To identify key risk factors associated with unplanned hospital admission following rhytidectomy.
- To improve the accuracy of discharge predictions for rhytidectomy patients.
- To inform perioperative strategies for reducing unplanned admissions.
Main Methods:
- A retrospective review was conducted on patients undergoing rhytidectomy at a tertiary care center from June 2022 to July 2025.
- Data collected included patient demographics, comorbidities, surgical details, and anesthetic agents used.
- Statistical analysis compared characteristics of patients discharged same-day versus those with unplanned admission.
Main Results:
- Out of 129 patients, 16.3% required unplanned admission.
- Unplanned admission was significantly associated with longer anesthesia duration (p=0.001), more concurrent procedures (p=0.002), obesity (p=0.024), higher ASA class (p=0.048), and hypertension (p=0.016).
- Specific anesthetic agents like dexmedetomidine and hydromorphone were linked to admission, while remifentanil use correlated with same-day discharge (p=0.010).
Conclusions:
- Factors such as extended anesthesia time, multiple concurrent surgeries, obesity, hypertension, and specific anesthetic choices predict unplanned admissions after rhytidectomy.
- Integrating these identified risk factors into perioperative planning can enhance discharge predictability.
- Improved resource allocation and patient safety can be achieved by better anticipating and managing patients at higher risk for readmission.
