Excess Costs and Length of Hospital Stay Attributable to Perioperative Respiratory Events in Children

Abstract

The effects of PRE in pediatric anesthesia were hospital stay after surgery, 2 times longer hospitalization, 30% higher excess hospital costs, and 58% higher indirect cost among outpatients. Hospital policy to efficiently manage hospital beds and compensatory budget should be developed.

Deep or awake removal of laryngeal mask airway in children at risk of respiratory adverse events undergoing tonsillectomy—a randomised controlled trial

“…Albeit occurring at a higher frequency in the awake group, perioperative respiratory adverse events such as coughing and oxygen desaturation were minor in nature and promptly resolved as indicated by the comparable amount of time spent in the PACU by children who experience these events and those who did not. These results contrast with recent findings from Oofuvong and colleagues, 21 where children experiencing perioperative respiratory adverse events were at an increased odds of hospital surgery, two times prolonged hospitalization after surgery, 30% higher excess hospital cost overall and 58% higher indirect cost amongst outpatients. Our intense PACU monitoring and 1:1 nurseepatient ratio may explain the lack of a difference in time spent in PACU between the children who presented with a perioperative respiratory adverse event and those who did not since any symptoms very immediately recognized and acted upon without delay.…”

Risk prediction tool for use and predictors of duration of postoperative oxygen therapy in children undergoing non-cardiac surgery: a case-control study

“…Even though we attempted to minimize the selection bias, some information bias from the database could have occurred. The incidence of a respiratory event during anesthesia in our study as well as some patient-related factors such as snoring and URI were quite low compared to a previous prospective study [ 24 ]. Finally, the child’s age, which might affect the need for postoperative oxygen therapy, could not be evaluated since it was used for matching.…”

“…A child with a hyper-reactive airway (due to asthma) is prone to develop bronchospasm or desaturation due to airway hypersensitivity to stimuli during anesthesia. Having a probable difficult airway [ 22 , 23 ] and prolonged anesthetic time [ 19 , 24 ] may lead to the need for postoperative oxygen therapy due to upper airway obstruction, desaturation, and perioperative reintubation. The ability to quickly and easily calculate a risk score for children undergoing non-cardiac surgery might help anesthesia personnel make decisions concerning the child’s management both at the preoperative and intraoperative periods.…”

Inhalational versus Intravenous Induction of Anesthesia in Children with a High Risk of Perioperative Respiratory Adverse Events

“…1 The incidence of perioperative respiratory adverse events is associated with increased airway reactivity and this association is strongest in individuals with asthma, eczema, a recent upper respiratory tract infection (URTI) or passive smoke exposure. [1][2][3][4][5] Perioperative respiratory adverse events are associated with an increased probability of prolonged hospital admissions and impact adversely on the patients and their families, surgery waitlists as well as lead to higher health care costs 6 . In cases where these events are not detected and treated early, they can lead to significant harm including death through hypoxia.…”