Impact Of Post-Anaesthesia Care Unit Delays On Older Post-Surgical Patients

Abstract Background Post-anaesthesia care units (PACUs) are critical for stabilising patients following surgery. Delays in transferring patients from PACU to ward or critical care settings can lead to bottlenecks in patient flow. Older individuals may be particularly vulnerable to such delays due to increased clinical complexity, slower physiological recovery, and higher rates of comorbidity. Methods A retrospective observational audit was conducted over a three-month period from October to December 2024. Data from 294 post-operative patients were analysed, including time of PACU admission and discharge and patient age. Descriptive statistics were used to calculate average, median, and range of PACU length of stay (LOS), with subgroup analysis comparing outcomes between older and younger patients. Results The average PACU LOS was 49 minutes, with a median of 20 minutes. The shortest stay was 5 minutes, and the longest was 7 hours. While most patients were discharged within an hour, 19% experienced prolonged stays. Patients aged over 65 years accounted for 32% of the sample, and 43% of them experienced PACU stays exceeding one hour, compared to only 12% of younger patients. Extended LOS in older individuals was often associated with delayed ward availability, prolonged monitoring, and challenges in meeting discharge criteria. These delays may contribute to postoperative complications such as delirium, hypothermia, and reduced mobilisation. Conclusion Older patients are disproportionately affected by PACU delays, which can impact recovery quality and increase hospital resource strain. Enhanced discharge protocols, improved inpatient bed coordination, and age-specific recovery pathways may help reduce LOS and improve outcomes. Further study is warranted to evaluate targeted interventions for this high-risk group. References 1. Kehlet, H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78:606–17. 2. Wong, DJN, Harris, SK, Moonesinghe, SR. Measuring outcomes in perioperative care: quality and impact of recovery. Anaesthesia. 2019;74:40–51.