Intensive care admissions of patients following surgery

Abstract

Objective: The aim of our study was to evaluate intensive care unit (ICU) admissions from the operating theatre, characterize the patient population and to determine those pre-operative, intra-operative and immediate postoperative risk factors that predict unplanned intensive care admission. Methods: The ICU treatment sheet, nursing records and anaesthetic record charts of three months (June-August 2007). All patients who had at least one overnight stay after surgery were included in the analysis. Results: During this period, there were 73 ICU admissions out of a total of 582 patients that had anaesthesia for various surgical procedures. Intensive care unit (ICU) admissions were categorised into two groups: PLANNED(patients for whom the anaesthetists decided pre-operatively that intensive care unit admission would be necessary) and UNPLANNED (patients in whom the need for ICU admission was not anticipated pre operatively).An unplanned ICU admission rate of 16.7% was observed. Factors associated with unplanned ICU admission included; duration of anaesthesia greater than 120 minutes and anaesthesia provided by a senior registrar. Surgery performed by senior registrar, increasing American Society of Anesthesiologist's physical status classification (ASA) and surgical procedures were predictors of poor outcome. Conclusion: This audit of post-operative intensive care unit admissions has provided valuable insight into our standards of anaesthetic practice and will allow us to implement changes in our practice.

Keywords: Intensive care; Post-operative admissions