Oh Tak Kyu1, Eunjeong Ji2, Soyeon Ahn3, Dong Jung Kim3, In-Ae Song4. 1. Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam 463-707 South Korea. 2. Medical Research Collaborating Centre, Seoul National University Bundang Hospital, South Korea. 3. Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, South Korea. 4. Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam 463-707 South Korea. Electronic address: songoficu@outlook.kr.
Abstract
BACKGROUND: This study aimed to investigate the association between postoperative surgical Intensive Care Unit (ICU) admission during a time when there was intensivist coverage and 30-day mortality after ICU admission. METHODS: This was a retrospective observational study in a tertiary care academic hospital ICU, with daytime intensivist coverage. We collected the electronic medical records for all patients who were admitted to the postoperative ICU after undergoing a surgery between January 1, 2007 and December 31, 2016. The primary outcome was to examine the differences in 30-day mortality after ICU admission according to ICU admission during times of intensivist or non-intensivist coverage. RESULTS: Overall, 13,906 patients were included (6634 [47.7%] patients were admitted with intensivist coverage, and 7272 [52.3%] patients without intensivist coverage). After performing propensity Score matching, 10,708 patients (5354 patients in each group) were analysed. In the matched cohorts, 30-day mortality after postoperative ICU admission in the group without intensivist coverage was higher than that with intensivist coverage [30-day mortality, 251/5354 (4.7%) and 173/5354 (3.2%) in the groups without and with intensivist coverage, respectively, P < 0.001]. Post-operative ICU admission in the group without intensivist coverage was associated with an increased risk of 30-day mortality (risk ratio: 1.45, 95% confidence interval: 1.20-1.75, P < 0.001). CONCLUSION: This study showed an increase in post-operative 30-day mortality, and length of hospital and ICU stay for surgical ICU admission among those without intensivist coverage.
BACKGROUND: This study aimed to investigate the association between postoperative surgical Intensive Care Unit (ICU) admission during a time when there was intensivist coverage and 30-day mortality after ICU admission. METHODS: This was a retrospective observational study in a tertiary care academic hospital ICU, with daytime intensivist coverage. We collected the electronic medical records for all patients who were admitted to the postoperative ICU after undergoing a surgery between January 1, 2007 and December 31, 2016. The primary outcome was to examine the differences in 30-day mortality after ICU admission according to ICU admission during times of intensivist or non-intensivist coverage. RESULTS: Overall, 13,906 patients were included (6634 [47.7%] patients were admitted with intensivist coverage, and 7272 [52.3%] patients without intensivist coverage). After performing propensity Score matching, 10,708 patients (5354 patients in each group) were analysed. In the matched cohorts, 30-day mortality after postoperative ICU admission in the group without intensivist coverage was higher than that with intensivist coverage [30-day mortality, 251/5354 (4.7%) and 173/5354 (3.2%) in the groups without and with intensivist coverage, respectively, P < 0.001]. Post-operative ICU admission in the group without intensivist coverage was associated with an increased risk of 30-day mortality (risk ratio: 1.45, 95% confidence interval: 1.20-1.75, P < 0.001). CONCLUSION: This study showed an increase in post-operative 30-day mortality, and length of hospital and ICU stay for surgical ICU admission among those without intensivist coverage.