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Annals of Intensive Care

, 6:42

First Online: 30 April 2016Received: 13 July 2015Accepted: 21 March 2016

Abstract

BackgroundPatients undergoing intermediate-risk surgery are typically taken to the ward postoperatively. However, some may develop complications requiring intensive care later. We aimed to evaluate the characteristics of patients undergoing intermediate-risk surgery who required late postoperative admission to the intensive care unit ICU and determine the predictors for this.

MethodsThe study included patients undergoing intermediate-risk surgery with preoperative indication for ICU but who were taken to the ward postoperatively, because they appeared to be responding well. However, they required late ICU admission. ICU care and preoperative SAPS 3 score were evaluated. Palliative surgeries and patients readmitted to ICU were excluded.

ResultsThe study included 100 patients, 27 % of whom had late postoperative admission to the ICU. The preoperative SAPS 3 score was higher 45.4 ± 7.8 vs. 35.9 ± 7.4, P < 0.001 in patients who required delayed admission to the ICU postoperatively. Furthermore, they had undergone longer surgery 4.2 ± 1.9 vs. 2.7 ± 1.5 h, P < 0.001, and a greater proportion were gastrointestinal surgeries 14.8 vs. 5.5 %, P = 0.03 and intraoperative transfusion 18.5 vs. 5.5 % P = 0.04. In multivariate analysis, preoperative SAPS 3 and surgery duration independently predicted postoperative ICU admission, respectively OR 1.25; 95 % CI 1.1–1.4 and OR 3.33; 95 % CI 1.7–6.3.

ConclusionThe identification of high-risk surgical patients is essential for proper treatment; time of surgery and preoperative SAPS 3 seem to provide a useful indication of risk and may help better to characterize patients undergoing intermediate-risk surgery that demand ICU care.

KeywordsSurgical patients Risk Intensive care unit Criteria An erratum to this article can be found at http:-dx.doi.org-10.1186-s13613-016-0180-2.

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Autor: João M. SilvaJr. - Helder Marcus Costa Rocha - Henrique Tadashi Katayama - Leandro Ferreira Dias - Mateus Barros de P

Fuente: https://link.springer.com/







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