skip to main content

Risk Factors and Impact of Surgery Type on Prolonged PACU Stay: A Modified Data Analysis

Universitas Bhakti Kencana Bandung, Indonesia

Received: 16 Jul 2025; Revised: 24 Feb 2026; Accepted: 30 Mar 2026; Available online: 1 Apr 2026.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

Citation Format:
Cover Image
Abstract

Background: Prolonged Post-Anesthesia Care Unit (PACU) stay represents a critical indicator of postoperative care efficiency and resource utilization. Extended PACU duration can lead to patient accumulation, increased complication risks, and healthcare system strain.

Objective: To identify and analyze risk factors associated with prolonged PACU stay following general anesthesia, with particular emphasis on surgery type as a dominant predictor.

Methods: A cross-sectional observational study was conducted using modified data from 96 patients undergoing general anesthesia. Data collection included patient demographics, ASA physical status, pain scores, surgical duration, comorbidities, surgery type, anesthesia technique, and patient transfer timing. Statistical analysis employed chi-square tests and logistic regression to identify significant predictors of prolonged PACU stay (≥30 minutes).

Result: Among 96 patients, 37.5% experienced prolonged PACU stay (≥30 minutes). Significant predictors included age (p=0.011), ASA physical status (p=0.012), anesthesia technique (p=0.035), and surgery type (p=0.001). Multivariate logistic regression identified surgery type as the dominant factor (p=0.004, OR=2.524, 95% CI: 1.355-4.700). Major surgeries demonstrated 60% prolonged stay rates compared to 21.8% for minor procedures. Pain intensity, surgical duration, comorbidities, and patient pickup time showed no significant association.

Conclusion: Surgery type emerges as the primary determinant of prolonged PACU stay, with major surgical procedures significantly increasing recovery duration. These findings provide evidence-based guidance for perioperative planning, resource allocation, and quality improvement initiatives in postoperative care.

Note: This article has supplementary file(s).

Fulltext |  common.other
Ethical clearance
Subject
Type Other
  Download (187KB)    Indexing metadata
Email colleagues
Keywords: asa physical status; general anesthesia; pacu length of stay, postoperative recovery, surgery type
Funding: Universitas Bhakti Kencana

Article Metrics:

  1. Gwinnutt C. Lecture Notes: Clinical Anaesthesia 2nd Edition. Vol. 41, Blackwell Publishing. 2004. 91 p
  2. WHO. Global Patient Safety Report 2024. Vol. 15, World Health Organization. 2024. 37–48 p
  3. Kementrian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia. Kementerian Kesehatan Republik Indonesia, Jakarta. 2023. 7–32 p
  4. Noprianty R, Putri RA, Manuopo H. Compliance in Filling Surgical Safety Checklist at The Central Surgical Installation. JAI (Jurnal Anestesiol Indones. 2024;16(3):208–17
  5. El Aoufy K, Forciniti C, Longobucco Y, Lucchini A, Mangli I, Magi CE, et al. A Comparison among Score Systems for Discharging Patients from Recovery Rooms: A Narrative Review. Nurs Reports. 2024;14(4):2777–94
  6. Briggs KM, Botti M, Phillips NM, Bowe SJ, Street M. Patient, surgical and clinical factors associated with longer stay in the Post Anaesthesia Care Unit. J Perioper Nurs. 2022;35(1):e26–36
  7. Kesarimangalam MHP, Hegde PM. Identification of Risk Factors Contributing to Prolonged Stay in the Post-anaesthesia Care Unit at a Tertiary Care Hospital in Abu Dhabi, United Arab Emirates. Cureus. 2023;15(3):1–6
  8. Alghamdi L, Filfilan R, Alghamdi A, Alharbi R, Kayal H. Factors Associated With Prolonged-Stay Patients Within the Post-anesthesia Care Unit: A Cohort Retrospective Study. Cureus. 2024;206(5):4–11
  9. Tully JL, Zhong W, Simpson S, Curran BP, Macias AA, Waterman RS, et al. Machine Learning Prediction Models to Reduce Length of Stay at Ambulatory Surgery Centers Through Case Resequencing. J Med Syst [Internet]. 2023;47(1):1–9. Available from: https://doi.org/10.1007/s10916-023-01966-9
  10. Nintakarn R, Paksiri W, Thabthim P, N JKR, Sangsungnern P. Optimal Timing for Postanesthesia Care Unit Discharge Using Study. 2025;43(3):1–8
  11. Chaudhry M, Shafi I, Mahnoor M, Vargas DLR, Thompson EB, Ashraf I. A Systematic Literature Review on Identifying Patterns Using Unsupervised Clustering Algorithms: A Data Mining Perspective. Symmetry (Basel). 2023;15(9):1–44
  12. Cusack B, Buggy DJ. Anaesthesia, analgesia, and the surgical stress response. BJA Educ [Internet]. 2020;20(9):321–8. Available from: https://doi.org/10.1016/j.bjae.2020.04.006
  13. Li; DCW, Rudloff S, Langer HT, Norman K, Herpich C. Age-Associated Differences in Recovery from Exercise-Induced Muscle Damage. cells. 2024;13(255):473,474
  14. Fang F, Liu T, Li J, Yang Y, Hang W, Yan D, et al. A novel nomogram for predicting the prolonged length of stay in post-anesthesia care unit after elective operation. BMC Anesthesiol [Internet]. 2023;23(1):1–12. Available from: https://doi.org/10.1186/s12871-023-02365-w
  15. Al-Husinat L, Azzam S, Sharie S Al, Al Hseinat L, Araydah M, Al Modanat Z, et al. Impact of the American Society of Anesthesiologists (ASA) classification on hip fracture surgery outcomes: insights from a retrospective analysis. BMC Anesthesiol. 2024;24(1)
  16. Noprianty R, Mutmainah I, Wahdana W, Wahyudi FM. Compliance with the implementation of pre-anesthesia assessment toward the prevention of adverse events in the operating room. 2025;133(1):48–59
  17. Kim DH, Yun HJ, Park S, Leem JG, Karm MH, Choi SS. Comparison between total intravenous anesthesia and balanced anesthesia on postoperative opioid consumption in patients who underwent laparoscopic-assisted distal gastrectomy. Med (United States). 2020;99(19):1–7
  18. Ahmed MM, Tian C, Lu J, Lee Y. Total Intravenous Anesthesia Versus Inhalation Anesthesia on Postoperative Analgesia and Nausea and Vomiting After Bariatric Surgery: A Systematic Review and Meta-Analysis. Asian J Anesthesiol. 2021;59(4):135–51
  19. Warda G. Efficacy of Antiemetic Drugs in Preventing Nausea and Vomiting in Patients Undergoing General Anesthesia: A Systematic Review. Acad Med Surg. 2024;1–9
  20. Abebe B, Kifle N, Gunta M, Tantu T, Wondwosen M, Zewdu D. Incidence and factors associated with post-anesthesia care unit complications in resource-limited settings: An observational study. Heal Sci Reports. 2022;5(3):1–9
  21. Yu L, Dong Y, Shi S, Liu X, Wang M, Jiang G. Analysis of postoperative nausea and vomiting in patients with lung cancer undergoing thoracoscopic surgery under general anesthesia and its influencing factors: a observational study. BMC Surg. 2024;24(1)
  22. David V-V, Merith G-M, Arturo L-O, Angélica G-ML, Esteban C-RC, Cuellar-Garduño N, et al. Systematized review of the literature on postoperative nausea and vomiting. J Anesth Crit Care Open access. 2023;15(3):101–7
  23. Noprianty R, Wahdana W, Suryanah A. Dampak Beban Kerja terhadap Produktifitas Kerja di Ruang Perioperasi. J Kepemimp dan Manaj Keperawatan. 2022;5(2)

Last update:

No citation recorded.

Last update: 2026-05-14 09:34:45

No citation recorded.