Analysis of the characteristics of unplanned admission to the intensive care unit after general surgery
10.17085/apm.2019.14.2.230
- Author:
Jaesuk KIM
1
;
Yeong Deok KIM
;
Dong Reul LEE
;
Kye Min KIM
;
Woo Yong LEE
;
Sangseok LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. s2248@paik.ac.kr
- Publication Type:Original Article
- Keywords:
Anesthesia;
Critical care;
General surgery;
Intensive care units;
Perioperative care
- MeSH:
Adult;
Anesthesia;
Anesthesia, General;
APACHE;
Biomarkers;
Cohort Studies;
Critical Care;
Critical Illness;
Electronic Health Records;
Hospital Mortality;
Humans;
Incidence;
Intensive Care Units;
Length of Stay;
Mortality;
Patient Safety;
Perioperative Care;
Retrospective Studies;
Thyroid Gland
- From:Anesthesia and Pain Medicine
2019;14(2):230-235
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Unplanned intensive care unit admission (UIA) is associated with perioperative morbidity and mortality, and can be used as a surrogate marker for patient safety. This study aimed to compare the characteristics of planned and unplanned intensive care unit (ICU) admission groups. METHODS: We retrospectively reviewed the electronic medical records of adult patients admitted to the ICU after abdominal and thyroid surgery under general anesthesia between 2016 and 2017. Preoperative, intraoperative, and postoperative information of enrolled patients was recorded. We compared patients' characteristics and outcomes between the unplanned and planned admission groups. RESULTS: In the total cohort, the proportion of UIA was 82.8% (202/244). In the unplanned admission group, total hospital stay was significantly shorter and ICU stay longer than that in the planned admission group (19.0 and 3.0 days, respectively vs. 28.5 and 2.0 days, respectively). In-hospital mortality rates were 21.3% and 7.1% in the unplanned and planned groups, respectively (P = 0.055). Patients in the UIA group showed higher Acute Physiology And Chronic Health Evaluation II scores, higher American Society of Anesthesiologist physical status class, and more co-morbidities than those in the planned group. There were significant differences in the incidence of UIA among surgery types. CONCLUSIONS: The UIA group had a relatively high mortality rate and longer ICU stay. More critically ill patients tended to be admitted to the ICU without planning.
