Anesth Pain Med.  2019 Apr;14(2):230-235. 10.17085/apm.2019.14.2.230.

Analysis of the characteristics of unplanned admission to the intensive care unit after general surgery

• Kim J
• Kim YD
• Lee DR
• Kim KM
• Lee WY
• Lee S

• KMID: 2447975
• DOI: http://doi.org/10.17085/apm.2019.14.2.230

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.

Keyword

Anesthesia; Critical care; General surgery; Intensive care units; Perioperative care

MeSH Terms

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
Biomarkers

Figure

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  Fig. 1 Study design and flow graph. ICU: intensive care unit.

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