BACKGROUND: Postoperative admission to the surgical intensive care unit (S-ICU) is routinely planned in order to prevent and treat early complications. Currently, limited studies have been conducted on this topic, and as such, early morbidity and mortality in patients undergoing postoperative intensive care were investigated. METHODS: This prospective analysis was performed in the S-ICU of a University hospital and included 1045 consecutive patients. All patients underwent elective surgery and were admitted to the S-ICU on the basis of preoperative clinical assessment. On the second, seventh, and thirtieth postoperative days, the location of the patients was recorded (ICU, surgical ward, or home) as were any complications that occurred. Predicted mortality and morbidity were assessed using the POSSUM score. RESULTS: The observed postoperative mortality rate was 2.4% (95% CI: 1.5-3.3%), which was much lower than the rate predicted by both POSSUM (6.2%) and P-POSSUM (5.3%) analyses, and 36% of patients experienced complications, a percentage slightly higher than that predicted by POSSUM (30.2%). The first 48 hours following surgery were characterized by the highest mortality rate (2.85 deaths per thousand vs 0.7 per thousand by the third postoperative day) as well as the highest morbidity rate (7.7% vs 4.3% between the third and seventh postoperative days, and 0.9% between the eighth and thirtieth postoperative days). The presumed causes of early death were primarily secondary to cardiovascular complications (five out of six). CONCLUSIONS: The first 48 hours after surgery is a critical period in high-risk patients, and a stay in the S-ICU should be seriously considered. Planned admission to the S-ICU may effectively decrease postoperative mortality, as suggested by the highly significant difference between expected and observed deaths following S-ICU admission.
BACKGROUND: Postoperative admission to the surgical intensive care unit (S-ICU) is routinely planned in order to prevent and treat early complications. Currently, limited studies have been conducted on this topic, and as such, early morbidity and mortality in patients undergoing postoperative intensive care were investigated. METHODS: This prospective analysis was performed in the S-ICU of a University hospital and included 1045 consecutive patients. All patients underwent elective surgery and were admitted to the S-ICU on the basis of preoperative clinical assessment. On the second, seventh, and thirtieth postoperative days, the location of the patients was recorded (ICU, surgical ward, or home) as were any complications that occurred. Predicted mortality and morbidity were assessed using the POSSUM score. RESULTS: The observed postoperative mortality rate was 2.4% (95% CI: 1.5-3.3%), which was much lower than the rate predicted by both POSSUM (6.2%) and P-POSSUM (5.3%) analyses, and 36% of patients experienced complications, a percentage slightly higher than that predicted by POSSUM (30.2%). The first 48 hours following surgery were characterized by the highest mortality rate (2.85 deaths per thousand vs 0.7 per thousand by the third postoperative day) as well as the highest morbidity rate (7.7% vs 4.3% between the third and seventh postoperative days, and 0.9% between the eighth and thirtieth postoperative days). The presumed causes of early death were primarily secondary to cardiovascular complications (five out of six). CONCLUSIONS: The first 48 hours after surgery is a critical period in high-risk patients, and a stay in the S-ICU should be seriously considered. Planned admission to the S-ICU may effectively decrease postoperative mortality, as suggested by the highly significant difference between expected and observed deaths following S-ICU admission.
Authors: Sarah Scott; Jonathan N Lund; Stuart Gold; Richard Elliott; Mair Vater; Mallicka P Chakrabarty; Thomas P Heinink; John P Williams Journal: BMC Anesthesiol Date: 2014-11-18 Impact factor: 2.217
Authors: Stephen A Smith; Jennifer M Yamamoto; Derek J Roberts; Karen L Tang; Paul E Ronksley; Elijah Dixon; W Donald Buie; Matthew T James Journal: Med Care Date: 2018-02 Impact factor: 2.983
Authors: Tormund S Njølstad; Henrica M Werner; Janusz Marcickiewicz; Solveig Tingulstad; Anne C Staff; Klaus Oddenes; Line Bjørge; Marie E Engh; Kathrine Woie; Jostein Tjugum; Margaret S Lode; Frederic Amant; Helga B Salvesen; Jone Trovik Journal: PLoS One Date: 2017-08-03 Impact factor: 3.240