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Incidence and Risk Factors of Delayed Discharge in Ambulatory Surgery Patients: A Systematic Review and Meta-Analysis
Summary
The delayed discharge rate in ambulatory surgery is 20%, influenced by patient factors like age, comorbidities, and postoperative symptoms. Addressing these multifactorial risks requires coordinated care to improve surgical quality.
Area of Science:
- Ambulatory surgery quality improvement
- Medical service metrics
- Healthcare quality research
Background:
- Delayed discharge is a key quality indicator in ambulatory surgery.
- Current evidence on delayed discharge rates and risk factors is limited.
- Understanding these factors is crucial for enhancing patient care and operational efficiency.
Purpose of the Study:
- To determine the incidence of delayed discharge in ambulatory surgery.
- To identify key sociodemographic, preoperative, intraoperative, and postoperative risk factors.
- To provide evidence for clinical practice guidelines and quality improvement initiatives.
Main Methods:
- Systematic review and meta-analysis of 14 studies.
- Inclusion of 41,862 patients.
- Quality assessment using Newcastle-Ottawa Scale and GRADE approach.
Main Results:
- Pooled delayed discharge rate of 20%.
- Identified risk factors: older age, female sex, prior surgery, non-local care, diabetes, cardiac/pulmonary insufficiency, ASA class ≥3, prolonged operative duration, nausea/vomiting, pain, and abnormal body temperature.
- Significant associations found for multiple risk factors.
Conclusions:
- Delayed discharge in ambulatory surgery is multifactorial.
- Multidisciplinary collaboration is essential for risk stratification.
- Personalized management strategies are needed to standardize ambulatory surgery practices.
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