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Received: 31 January 2022
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Revised: 29 April 2022
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Accepted: 6 May 2022
DOI: 10.1002/hsr2.649
ORIGINAL RESEARCH
Incidence and factors associated with post‐anesthesia
care unit complications in resource‐limited settings:
An observational study
Bisrat Abebe
1
|Natnael Kifle
2
|Muluken Gunta
3
|Temesgen Tantu
4
|
Mekete Wondwosen
5
|Dereje Zewdu
6
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
Correspondence
Dereje Zewdu, Department of Anesthesia,
College of Medicine and Health Science,
Wolkite University, P.O. Box: 07, Wolkite,
Ethiopia,
Email: Derejezewdu1529@gmail.com
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.
Health Sci. Rep. 2022;5:e649. wileyonlinelibrary.com/journal/hsr2
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https://doi.org/10.1002/hsr2.649
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any
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© 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC.
KEYWORDS
anesthesia, postanesthesia care unit, postoperative complications
1|INTRODUCTION
Postoperative complications in patients admitted to postanesthesia
care units (PACU) are frequent encounters and approximately
account for 4.25%–37.3%, with severity ranging from trivial to
critical incidents.
1–5
Complications types may differ in literature for various reasons:
however, the most frequently encountered PACU complications
were respiratory, cardiovascular, hypothermia, pain, postoperative
nausea and vomiting (PONV), and central nervous system‐related
adverse events.
6–13
According to the review reports of the Anesthesia Closed Claims
Project (CCP) database, the leading cause of anesthesia‐related
malpractice claims is the breakdown in communication.
14
The operating room (OR), the PACU, and the intensive care unit
(ICU) are particularly vulnerable to communication failures between
clinicians.
Ineffective communication in the PACU affects health‐care
expenses, length of hospital stays, unplanned ICU admission,
mortality, and morbidity.
15–17
The dearth of interventional studies revealed that the implemen-
tation of a checklist decreased the overall medical errors and rate of
preventable adverse events in PACU.
18–20
Another study also
showed that using the postanesthetic care tool (PACT) improves
early detection of patients at risk of deterioration, handover to
surgical ward nurses, and reduces health care expenses.
21
Therefore, prevention and management strategies based on
implementing standardized handover protocols, proper staffing of
well‐trained experts, monitoring devices, and infrastructures to
improve the quality of patient care should be a crucial part of safe
anesthesia in PACU.
22,23
In previously published studies, patient, anesthesia, and surgery‐
related risk factors have been identified for PACU complications.
Further explorations into the etiology of these complications should
help for developing strategies to prevent and manage those critical
incidents.
The recommendation and guidelines proposed vary considerably
between clinical setups in a diverse health context; hence resource‐
oriented local solutions to each health system, particularly in
resource‐limited settings should be considered.
24,25
In a four‐centered study done in Canada, american society of
anesthesiology (ASA) physical status, length of anesthesia duration,
the occurrence of intraoperative complications, and use of pure
spinal or narcotic techniques have been identified as independent
single risk factors for PACU complications.
10
On the other hand, the study done in the Philippines revealed
that duration of surgery, the occurrence of intraoperative complica-
tions, and postoperative complications were identified as significant
predictors for the length of stay at PACU.
26
Despite the magnitude of the problem in daily clinical activity,
there has been very little or no research examining the incidence and
factors associated with PACU complications in sub‐Saharan countries
including Ethiopia. The main objective of this study is to evaluate the
incidence of complications and associated factors among surgical
patients admitted in limited‐resource settings of the PACU.
2|METHODS AND MATERIALS
2.1 |Study design, settings, and patients
A hospital‐based observational study was employed from February
01 to May 30, 2021, in St. Paul's millennium medical college and
teaching hospital, Ethiopia.
This study was reported in line with STROCSS criteria and
registered at www.researchregistry.com with research registry UIN:
research registry 7482.
The study was approved by the St. Paul's hospital ethical
clearance committee and informed written consent was obtained
from each study participant and/or legal guardians of underage study
participants. Confidentiality was assured throughout the research.
2.2 |Inclusion criteria
During the study period, we included all surgical patients who were
admitted to PACU for monitoring and stabilization into this study.
2.3 |Exclusion criteria
Patients transferred directly from the operation theater to an ICU,
ward, or outpatient department were excluded.
2.4 |Postoperative and postanesthesia care
On the arrival of patients from the OR to the PACU, the responsible
nurses applied standard monitoring. Cardiovascular variables (HR,
DBP, and SBP) were measured using noninvasive monitoring devices.
Respiratory‐related variables (oxygen saturation, breathing pattern,
and respiratory rate) were observed using pulse oximetry and clinical
observation. Other adverse events (pain, PONV, hypothermia,
consciousness level, bleeding from the incision site, and unplanned
ICU admission) were monitored.
General anesthesia was induced using either intravenous or
inhalational anesthetics agents with muscle relaxants to facilitate
tracheal intubation. Inhalational agents and opioids were used for the
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maintenance of anesthesia and analgesia respectively. After the
surgery was completed, reversal agents were administered before
extubation and transferred to PACU depending on the patients'
physiologic status and the clinical judgment of the responsible senior
anesthetist.
In our setup, the overall activities including staffing and infra-
structures provided in PACU are suboptimal compared to the standard
of care recommended by the American Society of Anesthesiology.
27
The timing of monitoring and documentation depends on the
patients' physiologic status and varied among care providers of the unit.
Moreover, there are no standardized pain management protocols and
discharge criteria. The unit provides minimal to intermediate care for
surgical patients who may require close observation of vital signs,
temporary noninvasive ventilation, and hemodynamic support. This
single unit is equipped with six beds to provide services for all patients
regardless of the age group and type of surgery
Nurses are available at all times, and anesthetists/anesthesiologists
supervise the overall activities based on patients' conditions. However,
the nurses working in our setup didn't receive any kinds of training in
PACU. In the institution, there is a lack of a uniform and standardized
checklist used for discharging the patients from one department to
another; however, each patient admitted to PACU was monitored for a
minimum of 1–4 h, and discharged to the respective wards/units.
The primary outcome of our study was to estimate the incidence
of any complications in patients admitted to PACU. Complications
were categorized into respiratory‐related complications (including
desaturation, stridor, and wheezing), cardiovascular (hypotension,
hypertension, bradycardia, tachycardia, and shock), central nervous
system (agitation, deep sedation, seizure, and confusion), and 0ther
complications (excessive pain, hypothermia, bleeding from the
incision site, reintubation, and unplanned ICU admission). Operational
terms of complications are presented in Table 1.
TABLE 1 Operational definitions of terms
Management
Desaturation Oxygen saturation <94% checked by pulse oximetry Noninvasive ventilation
Airway maneuvers
Stridor High‐pitched sound during inspiration CPAP
Wheezing High‐pitched sound during expiration
Hypertension: A systolic BP > 160 mmHg for longer than 5 min and/or
increased by 20% from baseline
Fluid restriction
vasodilators
Hypotension: A diastolic BP < 90 mmHg for longer than 5 min and/or
decreased by 20% from baseline
Fluid administration
Vasopressors
Tachycardia Heart rate >100 for adults, different in different pediatric age
groups
Observation
Bradycardia Heart rate <60 for adults and less than 80 for children Oxygen
Atropine
Excessive pain Moaning or screaming, writhing in pain at any time in PACU or
initial care dominated by pain control or requiring more
analgesic than ordered.
NSAIDs
Acetaminophen
Weak opioids
ICU admission Unplanned requirement of ICU admission before discharge
from PACU
ICU care
Re‐intubation Unplanned intubation before discharge from PACU Treating the underlying
causes
Hypothermia A temperature <36.5℃Cooling measures
PONV Nausea and/vomiting during PACU stay Fluid
Metoclopramide
Intraoperative
complications
A patient who developed any cardiovascular, and/or respiratory
adverse events (laryngospasm and/or bronchospasm and/or
aspiration) and/or significant blood loss.
Optimizing and treating
the underlying causes
Significant
blood loss
A total blood loss >30% of an estimated blood volume during
the intraoperative period
Blood transfusion
Abbreviations: CPAP, continuous positive airway pressure; ICU, intensive care unit; PACU, postanesthesia care unit; PONV, postoperative nausea and
vomiting.
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2.5 |Sample size and sampling techniques
We calculated the sample size from the primary outcome variable by
using single population formula, which is the incidence of PACU
complications. Since there is no preliminary data in the study setting
p= 0.5 (prevalence of PACU complications 50%) was taken for the
calculation to get the largest sample size, 95% confidence interval,
and 5% margin of error giving us 384 study subjects. Since the
studied population in a year is less than 10,000, the corrected sample
size formula was used, and the final sample size becomes 396 by
adding a 10% attrition rate. A convenient sampling technique was
used to select the study participants.
2.6 |Data collection techniques
We collected our data using a pretested questionnaire by trained 4
PACU nurses and anesthetists data collectors. Demographics and
preexisting co‐morbidity variables were documented from the patient
medical chart. The occurrences of complications and length of PACU
stay were recorded from bedside observation, monitoring devices,
and documentation of attending nurses until discharging patients to
the respective department. The data were cross‐checked by the
principal investigator to ensure accuracy and completeness.
2.7 |Data analysis
We entered and analyzed data using Statistical Package for Social
Sciences (SPSS version 26). We used descriptive statistics to summarize
the frequency table, and the standardized residual tests to test the
outlier data. Multicollinearity was checked by VIF, tolerance, and
confidence index. All independent variables were analyzed using
bivariate analysis, and the variables that had an association at a p‐
value less than or equal to 25 were entered into a multivariable logistic
regression model, and p‐value < 0.05 was considered to be a risk factor
for PACU complications during the postoperative period in this study.
The results of associated variables were presented as a frequency table,
crude, and adjusted odds ratio with a 95% confidence interval. Hosmer
Lemeshow test was used to check the goodness of the model, and the
model was the best fit with a p‐value of 689.
3|RESULTS
3.1 |Demographics and pre‐existing comorbidity
characteristics of the study participants
A total of 396 patients admitted to PACU during the study period
were enrolled for final analysis. Of these, 204 (51.51%)
were males and females accounted for 192 (48.49%). The mean
(SD) of the study participants was 38.99 (19.47) with a range of
4 months to 96 years. Regarding the ASA physical status, the majority
305 (77.02%) of patients were ASA class I followed by ASA class II 69
(17.42%) and ≥ASA class III 22 (5.56%). Assessment of preoperative
comorbidity revealed that only 94 (23.74%) of patients had pre‐
existing comorbidity as shown in Table 2.
3.2 |Anesthesia‐related characteristics of study
participants
Of all study participants, 296 (74.75%) had received general
anesthesia. With regard to the level of anesthesia care providers,
246(62.12%) of the procedures have been performed by residents
and anesthetists 150 (37.88%). Cases with intraoperative complica-
tions were observed only in 35 (8.34%) patients. The mean (SD)
duration of anesthesia and duration of stay in the PACU was 157.88
(86.87) and 170.74 (38.49), respectively (Table 3).
3.3 |Surgery‐related characteristics of study
participants
The majority of 298 (75.25%) types of surgery were elective, and the
rest 98 (24.75) were emergency. Regards to surgical indication by
specialty, most of them were general surgery 147 (37.12%),
gynecology 44 (11.12%), orthopedics 43 (10.86%), and variety of
TABLE 2 Demographic characteristics of study participants
Variables Category Number Percent
Sex Male 204 51.51
Female 196 48.49
Age group ≤5 36 9.1
6–15 15 3.8
16–29 101 25.5
30–45 79 19.95
46–60 127 32.05
>60 38 9.6
ASA classification 1 305 77.02
2 69 17.42
≥3 22 5.56
Pre‐existing
comorbidity
None 302 76.26
Respiratory 9 2.27
cardio‐vascular
system
22 5.55
Neurological 3 0.76
Endocrine (DM) 17 4.3
reto‐viral infection 24 6.06
>1 Comorbidity 19 4.8
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pediatrics surgery 41 (10.35%). The majority of the surgical
procedures have been done in supine position 359 (90.66%). More
than two‐thirds of 304 (76.76%) surgical duration were between
0 and 3 h (Table 4).
3.4 |Incidence of PACU complications
Of the total study participants admitted to PACU, the total incidence
of PACU complications was 217 (54.8%) as shown in Figure 1. Among
those, 58 (14.64%) patients had developed more than one complica-
tion and only 14 (3.53%) of them had required unplanned reintuba-
tion and ICU admission.
3.5 |Types of PACU complications
With regard to the types of PACU complications, the majority of
patients were developed respiratory and airway related adverse
events 94 (43.32%) followed by PONV 48 (22.12%), and
cardiovascular related adverse events 41 (18.9%) as shown in
Table 5.
TABLE 3 Anesthesia‐related characteristics of study participants
Types of anesthesia General 296 74.75
Regional 60 15.15
Combined 24 6.06
monitored
anesthesia care
16 4.04
Level of anesthetist Anesthetist 150 37.88
Resident 246 62.12
Anesthesia duration
(hours)
0–2 h 172 43.43
2–3 h 106 26.77
3–4 h 77 19.45
>4 h 41 10.35
Intraoperative complication
presence
Yes 35 8.84
No 361 91.16
Duration of stay in the
postanesthesia care
unit
60–120 min 172 43.43
120–180 min 106 26.77
180–240 min 77 19.45
>240 min 41 10.35
TABLE 4 Surgery‐related characteristics of the study
participants
Variables Category Frequency Percent
Types of surgery Elective 298 75.25
Emergency 98 24.75
Surgical indication by
specialty
General surgery 147 37.12
Gynecology 44 11.12
Orthopedics 43 10.86
Pediatric surgery 41 10.35
Cardiothoracic 15 3.78
Hepato‐biliary 17 4.3
Uro‐surgery 32 8.08
Neurosurgery 29 7.32
ENT 28 7.07
Position during surgery Supine 359 90.66
Prone 13 3.28
Lateral 11 2.78
Lithotomy 13 3.28
Surgical time (hours) 0–2 h 144 36.36
2–3 h 160 40.4
3–4 h 60 15.15
>4 h 32 8.09
FIGURE 1 Incidence of complications among surgical patients
admitted to postanesthesia care units.
TABLE 5 Types of postanesthesia care unit complications of
study participants
Types of complications Frequency Percent
Airway and respiratory 94 43.32
cardio‐vascular system 41 18.9
Postoperative nausea and vomiting 48 22.12
central nervous system 19 8.76
Other complications 15 6.9
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3.6 |Patient, anesthesia, and surgery‐related
factors associated with PACU complications among
study participants
The results from multiple logistic regressions showed that female sex,
prolonged duration of anesthesia, intraoperative complications
presence, and length of stay in PACU were found to be statistically
significant with PACU complications.
Female sex (AOR = 2.570; 95% CI: 1.621–4.075), duration of
anesthesia greater than 4 h (AOR = 5.406; 95% CI: 2.418–12.088),
intraoperative complications occurrences (AOR = 2.238; 95%
CI: 0.991–5.056) and duration of PACU stay > hours 4.538
(2.089–9.857) had shown an association with postoperative compli-
cations in PACU (Table 6).
4|DISCUSSION
The infrastructure and staffing of PACU in low‐income countries are
often substandard; with less equipped monitoring, a limited number
of beds, a lack of locally adopted protocols, and trained health care
providers. These limitations significantly impact the clinical outcomes
of the early postoperative period. With such resource‐constrained
environments, standardizing the service became even more crucial to
improve the quality of care.
28,29
Certainly, it is desirable to ado pt prediction tools in surgical
patients, when the risk of postoperative complications is high,
but, staffing and medical resources of a particular clinical setup
should be considered. Developing risk prediction tools is not
enough, though. It can be used as a baseline source to develop
evidence‐based clinical pathways. Implementing and evaluating
the adopted clinical pathway to improve the quality of post-
operative care is the key.
15
This study aimed to evaluate the incidence of complications and
associated factors among surgical patients admitted in limited‐
resource settings of the PACU.
In our resource‐constrained setup, there is an inconsistently
predefined protocol for management and discharge criteria of patients,
that is, no or substandard clinical pathways. Thus, this study can serve
to identify problems and find solutions for countries with limited setup.
Despite most of the patients being ASA class I without
comorbidity, our study has revealed that the overall incidence of
postoperative complications in PACU among patients undergoing
surgery is 54.6%. In contradiction to our finding, previous studies
conducted in different countries using a varied standard of care had
reported that only (4.25%–37.3%) of surgical patients had developed
PACU complications.
1–4
This significant discrepancy could be explained by the fact that in
our study area there are traditional and inconsistent handover
trends,
16
limited nursing staff compared to workload intensity,
30
and
medical resources constraints to provide standardized care. By
implementing cost‐effective clinical pathways in routine practice,
the early identification of structural problems may significantly
improve patient care and postoperative outcome.
Of all PACU complications, the majorities (17.7%) were respiratory
and airway‐related complications. These findings are consistent with
previous studies.
5–7
The possible explanation for the high rate of
respiratory complications is due to hypoventilation caused by hypo‐
TABLE 6 Multivariate logistic regression analysis showing factors associated with PACU complications
Variables Category
PACU complication
COR (95% CI) AOR (95% CI) p‐valueNo Yes
Sex Male 117 87 1 1 <0.001
Female 62 130 2.820 (1.870–4.251) 2.570 (1.621–4.075)***
Duration of anesthesia hours 0–2 101 69 1 1
2–3 42 66 2.3 (1.404–3.767) 2.226 (1.330–3.725)** 0.002
3–4 26 51 2.871 (1.635–5.041) 3.050 (1.690–5.505)*** <0.001
>4 10 31 4.508 (2.089–9.857) 5.406 (2.418–12.088)*** <0.001
Intraoperative complication No 9 26 1 1 0.025
Yes 170 191 2.571 (1.172–5.641) 2.238 (0.991–5.056)**
Duration of PACU stay hours 1–212 61 1
2–3 80 74 2.300 (1.404–3.767) 1.226 (0.426–3.527) 0.242
3–4 44 62 2.871 (1.635–5.041) 1.898 (0.645–5.584) 0.054
>4 43 75 4.538 (2.089–9.857) 2.177 (0.741–6.401)** 0.020
Note: Statistically significant
Abbreviations: AOR, adjusted odds ratio; COR, crude odd ratio; PACU, postanesthesia care unit.
**p< 0.05; ***p< 0.001.
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active emergence and residual effects of muscle relaxant agents, as
most of the participants had undergone surgery with general anesthe-
sia.
4,31
In disagreement with our finding, other studies
8,9
reported that
the majority of PACU complications were cardiovascular‐related. In
another study, PONV,
10,31
central nervous system,
2,11
and pain
12,13
were reported as the most common PACU complications.
Depending upon the severity of complications, poorly managed
events in the early postoperative period can diversely impact the
clinical outcome; which may increase the length of hospital stays,
unplanned ICU admission, reintubation, and even death.
15–17
Therefore, prevention of critical incidents and provision of
evidence‐based care should be an integral role of standard patient
care in the PACU.
Our study found that female sex, duration of anesthesia,
presence of intraoperative complications, and duration of stay in
PACU were factors associated with PACU complications.
Female patients were more at risk of developing complications
than their male counterparts (AOR = 2.570; 95% CI: 1.621–4.075).
Similarly, other studies
12,32–34
also found that being a female is a risk
factor to develop PACU complications. This discrepancy could be
explained by the fact that: the higher incidence of PONV
35
and
postoperative pain
36
in female patients attributed to the high rate of
PACU complications. Provisions of preemptive analgesia and PONV
prophylaxis for female patients are crucial to improving postoperative
outcomes.
37,38
Another factor associated with PACU complications in the
present study was the duration of anesthesia. Duration of anesthesia
>4 h (AOR = 5.406; 95% CI: 2.418–12.088) and 2–3 h (AOR = 3.050
95% CI: 1.690–5.505) had five‐and three‐fold risk for developing
PACU complications compared to the duration of anesthesia less
than or equal to 2 h, respectively. This result is consistent with other
studies
6,10,32,39
that reported the risk of developing PACU complica-
tions is higher in patients with prolonged duration of anesthesia.
The intraoperative complications presence (AOR = 2.238; 95%
CI: 0.991–5.056) was a risk factor to predict PACU complications, as
revealed by the present study.
Different risk factors identified as challenging preoperatively
might be strongly associated with intraoperative complications. The
occurrences of intraoperative complications increased the likelihood
of postoperative morbidity and prolonged hospital stay (6, 7, and 10).
Therefore, the identification of risk factors for perioperative
complications and adequate optimization should be an integral part
of anesthetic management.
40
Inconsistent with our findings, other studies revealed that types
of anesthesia, the urgency of surgery, ASA class, preexisting disease,
and other factors are associated with PACU complications. The
standard of clinical setup, types of surgery performed, level of
expertise, available medications, sustainable training, and attention
given to the health sector might contribute to the dissimilarity of the
findings.
The length of stay in PACU greater than 4 h (AOR = 4.538; 95%
CI: 2.089–9.857) were strongly correlated with the incidence of
PACU complication, our study also observed that patients who
encountered PACU complications significantly required a prolonged
duration of stay than initially planned compared to patients without
complications.
9,26
4.1 |The limitation of the study
Our study had some limitations. First, we conducted our study in
resource‐limited settings of a single‐center hospital which is difficult
to conclude the overall features of the country. Second, this study
identified complications that exclusively occurred in PACU and failed
to detect any types of postoperative complications experienced by
patients after being discharged from PACU. Furthermore, we
included mixed population and diversified age groups which might
affect the confounding factors.
4.2 |Strength of the study
This study is prospective and observational used as a primary source
of data.
5|CONCLUSION
The incidence of PACU complications is 54.6% in the present study
which is higher than in prior studies done in different countries.
Female sex, intraoperative complications occurrence, and duration of
anesthesia are found to be independent risk factors for developing
PACU complications. Based on the present study's findings, we
recommend the PACU team needs to develop area‐specific institu-
tional guidelines and protocols to improve the patient outcomes in
PACU. We also recommend the researcher conduct a multi‐centered
study on a larger group of patients.
AUTHOR CONTRIBUTIONS
Bisrat Abebe: Conceptualization; data curation; formal analysis;
funding acquisition; investigation; methodology; project administra-
tion; resources; software; supervision; validation; visualization;
writing—original draft; writing—review and editing. Natnael Kifle:
Conceptualization; data curation; formal analysis; funding acquisition;
investigation; methodology; project administration; resources; soft-
ware; supervision; validation; visualization; writing—original draft;
writing—review and editing. Muluken Gunta: Conceptualization; data
curation; formal analysis; funding acquisition; investigation; method-
ology; project administration; resources; software; supervision;
validation; visualization; writing—original draft; writing—review and
editing. Temesgen Tantu: Conceptualization; data curation; formal
analysis; funding acquisition; investigation; methodology; project
administration; resources; software; supervision; validation; visual-
ization; writing—original draft; writing—review and editing. Mekete
Wondwosen: Conceptualization; data curation; formal analysis;
funding acquisition; investigation; methodology; project
ABEBE ET AL.
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administration; resources; software; supervision; validation; visual-
ization; writing—original draft; writing—review and editing. Dereje
Zewdu: Conceptualization; data curation; formal analysis; funding
acquisition; investigation; methodology; project administration;
resources; software; supervision; validation; visualization; writing—
original draft; writing—review and editing.
ACKNOWLEDGMENTS
The authors acknowledge St. Paul's hospital millennium medical
college for giving us ethical clearance. Our thanks also go to data
collectors and study participants for their invaluable support.
CONFLICTS OF INTEREST
The authors declare no conflicts of interest.
DATA AVAILABILITY STATEMENT
Data are available from the corresponding author upon reasonable
request.
TRANSPARENCY STATEMENT
Dereje Zewdu affirms that this manuscript is an honest, accurate, and
transparent account of the study being reported; that no important
aspects of the study have been omitted; and that any discrepancies from
the study as planned (and, if relevant, registered) have been explained.
ORCID
Mekete Wondwosen http://orcid.org/0000-0001-8595-5866
Dereje Zewdu http://orcid.org/0000-0001-9819-1842
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How to cite this article: 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. Health Sci. Rep. 2022;5:
e649. doi:10.1002/hsr2.649
ABEBE ET AL.
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