Day case discharges and criteria
A total of 860/1727 (49.8%) patients were discharged on the same day
following nasal and/or palatopharyngeal surgery. One study was excluded
from this analysis as the number of patients who were discharged on the
same day was not clear (11). A total of 33 patients (1.9%) stayed
overnight due to social reasons such as lack of transportation or at the
patient’s request (8, 12, 13).
There was a lack of details across the studies on the number of planned
day cases and the number of patients who were discharged on the same day
due to good postoperative clinical parameters. Four studies did not
report clear criteria for day cases (6, 11, 13, 14). Three studies
reviewed patients post-operatively in recovery or the post-anaesthetic
care unit (PACU) for desaturations prior to making a discharge decision
(12, 15, 16). All the patients with mild or moderate OSA (defined as AHI
≤ 30) were day cases in one study (10) although it was unclear if this
was predetermined. The remaining two studies based the discharge
decision on the type of surgery and surgeons’ preferences (7, 8).
Patients who had concurrent tongue surgery were usually admitted
overnight for observation.
Four studies had a lack of data on intensive care or high dependency
admissions among the inpatient group (6, 10, 13, 14). Two studies
reported no ITU admissions (n = 83) among inpatients (12, 13, 15) of
which one monitored all inpatients with continuous pulse oximetry
overnight (15). All the inpatients of two studies (n = 323) were
admitted to the high dependency unit or a similar ward set-up with a
higher nurse to patient ratio and continuous pulse oximetry monitoring
as a routine precaution (8, 16). Seventy five out of 216 (34.7%)
inpatients of the remaining two studies were admitted to intensive care
unit although the criteria for this was unclear and the level of
intervention each patient received was unclear (whether it is for
monitoring or if patients were kept intubated and ventilated) (7, 11).