Saqib Ali
Introduction
Target day case rates for all suitable procedures in the UK are set by the British Association of Day Surgery and published in the Directory of Procedures. Day case surgery is associated with improved patient outcomes, reduced hospital bed use, lower healthcare costs and less environmental impact. Day case performance is monitored locally by trusts, regionally by integrated care boards and nationally by organisations such as GiRFT.
Aim
This audit aimed to investigate the relationship between overnight stay and patient morbidity and mortality.
Methods
All patients undergoing inguinal hernia repair surgery between May 2024 and April 2025 in a single UK NHS Trust were identified. Data were collected on patient demographics, diagnosis, procedure, operative approach (open, laparoscopic or robotic), morbidity (including readmissions) and mortality. The relationships between overnight admission following surgery and morbidity / mortality were investigated.
Results
917 patients were identified. 818 patients (89.2%) were discharged on the same day as surgery and 99 patients (10.8%) stayed at least one night. Patients were followed up for an average of 15.5 months (range 9-21). During this period 12 patients died (1.3%). Mortality in patients staying overnight was 3.0% (3/99)
compared 1.1% (9/818) in daycase patients (P=0.13). 319 patients (34.8%) had at least one readmission. 45 (45.5%) patients staying overnight were readmitted compared with 274 (33.5%) daycase patients, (1.4-fold increase, P= 0.025).
Conclusions
Patients requiring overnight stay after inguinal hernia surgery showed a trend towards 2.8-fold increase in mortality and a 1.4-fold increase in overall readmissions compared with daycase patients.
Authors
David Bunting, Leen Nesnas, Imran Ali, Saqib Ali, Pranab Munankami
North Devon District Hospital, Barnstaple, United Kingdom