J Korean Surg Soc.  2012 Sep;83(3):155-161. 10.4174/jkss.2012.83.3.155.

Is close monitoring in the intensive care unit necessary after elective liver resection?

• Kim SH
• Lee JG
• Kwon SY
• Lim JH
• Kim WO
• Kim KS

• KMID: 2212288
• DOI: http://doi.org/10.4174/jkss.2012.83.3.155

Abstract

PURPOSE
Many surgical patients are admitted to the intensive care unit (ICU), resulting in an increased demand, and possible waste, of resources. Patients who undergo liver resection are also transferred postoperatively to the ICU. However, this may not be necessary in all cases. This study was designed to assess the necessity of ICU admission.
METHODS
The medical records of 313 patients who underwent liver resections, as performed by a single surgeon from March 2000 to December 2010 were retrospectively reviewed.
RESULTS
Among 313 patients, 168 patients (53.7%) were treated in the ICU. 148 patients (88.1%) received only observation during the ICU care. The ICU re-admission and intensive medical treatment significantly correlated with major liver resection (odds ratio [OR], 6.481; P = 0.011), and intraoperative transfusions (OR, 7.108; P = 0.016). Patients who underwent major liver resection and intraoperative transfusion were significantly associated with need for mechanical ventilator care, longer postoperative stays in the ICU and the hospital, and hospital mortality.
CONCLUSION
Most patients admitted to the ICU after major liver resection just received close monitoring. Even though patients underwent major liver resection, patients without receipt of intraoperative transfusion could be sent to the general ward. Duration of ICU/hospital stay, ventilator care and mortality significantly correlated with major liver resection and intraoperative transfusion. Major liver resection and receipt of intraoperative transfusions should be considered indicators for ICU admission.

Keyword

Hepatectomy; Major resection; Intensive care units; Intraoperative transfusion

MeSH Terms

Critical Care
Hepatectomy
Humans
Intensive Care Units
Liver
Medical Records
Patients' Rooms
Retrospective Studies
Ventilators, Mechanical

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