Incidence and factors associated with post-anesthesia care unit complications in resource-limited settings: An observational study

Bisrat Abebe; Natnael Kifle; Muluken Gunta; Temesgen Tantu; Mekete Wondwosen; Dereje Zewdu

doi:10.1002/hsr2.649

Incidence and factors associated with post-anesthesia care unit complications in resource-limited settings: An observational study

Health Sci Rep. 2022 May 23;5(3):e649. doi: 10.1002/hsr2.649. eCollection 2022 May.

Authors

Bisrat Abebe¹, Natnael Kifle², Muluken Gunta³, Temesgen Tantu⁴, Mekete Wondwosen⁵, Dereje Zewdu⁶

Affiliations

¹ Department of Anesthesiology and Critical Care Wolaita Sodo University Wolaita Sodo Ethiopia.
² Department of Anesthesiology and Critical Care Addis Ababa University Addis Ababa Ethiopia.
³ Department of Public Health Wolaita Sodo University Wolaita Sodo Ethiopia.
⁴ Department of Obstetrics and Gynecology Wolkite University Wolkite Ethiopia.
⁵ Department of Surgery Wolkite University Wolkite Ethiopia.
⁶ Department of Anesthesia Wolkite University Wolkite Ethiopia.

Abstract

Background and aims: Postoperative complications are frequent encounters in the patients admitted to postanesthesia care units (PACU). The main aim of this study was to assess the incidence of complications and associated factors among surgical patients admitted in limited-resource settings of the PACU.

Methods: This is an observational study of 396 surgical patients admitted to PACU. This study was conducted from February 1 to March 30, 2021, in Ethiopia. Study participants' demographics, anesthesia, and surgery-related parameters, PACU complications, and length of stay in PACU were documented. Multivariate and bivariate logistic regression analyses, the odds ratio (OR), and 95% confidence interval (CI) were calculated. p-value < 0.05 was considered as statistically significant.

Results: The incidence of complications among surgical patients admitted to PACU was 54.8%. Of these, respiratory-related complications and postoperative nausea/vomiting were the most common types of PACU complications. Being a female (adjusted odds ratio [AOR] = 2.928; 95% CI: 1.899-4.512) was significantly associated with an increased risk of developing PACU complications. Duration of anesthesia >4 h (AOR = 5.406; 95% CI: 2.418-12.088) revealed an increased risk of association with PACU complications. The occurrences of intraoperative complications (AOR = 2.238; 95% CI: 0.991-5.056) during surgery were also associated with PACU complications. Patients who develop PACU complications were strongly associated with length of PACU stay for >4 h (AOR = 2.177; 95% CI: 0.741-6.401).

Conclusion: The identified risk factors for complications in surgical patients admitted to PACU are female sex, longer duration of anesthesia, and intraoperative complications occurrences. Patients who developed complications had a long time of stay in PACU. Based on our findings, we recommend the PACU team needs to develop area-specific institutional guidelines and protocols to improve the patients' quality of care and outcomes in PACU.

Keywords: anesthesia; postanesthesia care unit; postoperative complications.