Clinical Characteristics and Outcomes of Surgical Patients with Intensive Care Unit Lengths of Stay of 90 Days and Greater

Martini, Verena; Lederer, Ann-Kathrin; Laessle, Claudia; Makowiec, Frank; Utzolino, Stefan; Fichtner‐Feigl, Stefan; Kousoulas, Lampros

doi:10.1155/2017/9852017

Cited by 13 publications

(17 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Admission to the intensive care unit (ICU) after surgery, although lifesaving, can be associated with significant morbidity and mortality as well as increased healthcare costs . No survival benefits have been associated with empiric ICU admission after elective surgery and thus identification of risk factors for post‐operative ICU admission presents an opportunity to improve patient outcomes and reduce hospital costs.…”

Section: Introductionmentioning

confidence: 99%

Post‐operative intensive care unit admission after elective non‐cardiac surgery: A single‐center analysis of the NSQIP database

Bruceta

Souza

Carr

et al. 2019

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Background: Admission to the intensive care unit (ICU) after surgery can be associated with significant morbidity and mortality. This observational cohort study aims to identify perioperative factors associated with post-operative ICU admission in patients undergoing elective non-cardiac surgery.Methods: Data from the ACS NSQIP ® database at a tertiary care academic medical center were analyzed from January 2011 to September 2016. Univariable and multivariable logistic regression of patient and surgery-specific characteristics was performed to assess association with post-operative ICU admission. The Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9) billing codes, as well as associated outcomes, were reviewed. Results:Of 5254 database patient records, 1150 met our inclusion criteria. Elevated body mass index (BMI), longer procedure duration and a diagnosis of disseminated cancer were associated with post-operative ICU admission. Prostatectomy and morbid obesity were the most common CPT and ICD-9 codes identified. Patients who were admitted to the ICU after surgery had a longer hospital length of stay (LOS), had a higher frequency of readmission, re-operation, and in-hospital mortality.Conclusion: Admission to the ICU after elective non-cardiac surgery is common. Our analysis of the ACS NSQIP ® database identified elevated BMI, longer duration of surgery and disseminated cancer as predictors of post-operative ICU admissions in patients undergoing elective non-cardiac surgery.

show abstract

Section: Introductionmentioning

confidence: 99%

Post‐operative intensive care unit admission after elective non‐cardiac surgery: A single‐center analysis of the NSQIP database

Bruceta

Souza

Carr

et al. 2019

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…We think that high mean age in our study contributed both to high mortality rate and shorter mean length of stay. In addition, the causes in LOS and mortality are multi-factorial and vary according to ICU characteristics (26).…”

Section: Discussionmentioning

confidence: 99%

Üçüncü Basamak Bir Yoğun Bakım Ünitesinde Bir Yıl Içinde Ölen Hastaların Klinik Özellikleri

Miniksar

Toy

2021

Medical Records

View full text Add to dashboard Cite

The aim of this study was to find out the clinical characteristics of patients who died within a year in the intensive care unit (ICU) and to find out the association of ICU admission albumin, lactate levels and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores of these patients who died with ICU length of stay. Material and Method: The files of patients who died in the ICU (n:350) between January 2018 and December 2018 were examined retrospectively. The patients' demographic data and their clinical characteristics, ICU admission types (surgery or medical medicine), the units they were admitted in, reasons for admission, comorbidities, admission albumin and lactate levels, APACHE II scores and ICU length of stay were recorded. The association of patients' clinical characteristics with ICU length of stay and laboratory values was evaluated. Result: The patients' mean age was 72.68±12.98 years, mean APACHE II score was 27.0±10.0, mean albumin value was 3.1±0.7 g/dL and mean lactate value was 4.1±3.3 mmol/L. It was found that albumin value was lower in patients admitted to ICU with mechanical ventilator (MV) need (p<0.001), and lactate value and APACHE II score were significantly higher in patients with post-cardiopulmonary resuscitation (p<0.001). Mean ICU length of stay was 28.24 ± 37.53 days. A weak positive correlation (r =0.172, p=0.001) was found between the patients' length of stay and albumin, and a weak negative correlation was found with the lactat (r = 0.121, p=0.023) and APACHE II scores (r = 0.151, p=0.001). A weak negative correlation was found between the patients' albumin and lactate (r =0.152, p=0.004), and APACHE II score (r =0.179, p=0.001), as well as a moderate positive correlation between lactate and APACHE II score. Conclusion: Significant association was found between hypoalbuminemia, hyperlactatemia and high APACHE II scores and ICU length of stay in patients who died in ICU. More comprehensive studies are needed to show the effects of this association on effective use of ICUs.

show abstract

“…Agencel et al (8) reported 9.3% of patients admitted to a tertiary ICU stayed for 21 days or longer. Martini et al (9) stated that surgical critical care patients stayed for a mean of 116 days. However, the ICU duration of stay for patients with respiratory diseases was identified as 24.17±8.38 days (10).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Long-term Intensive Care Patients in a Cardiac Surgery Center

Balkan¹,

Özcanoğlu²

2020

BMB

View full text Add to dashboard Cite

Objective: This study was aimed to evaluate the clinical and demographic characteristics of patients in a chronic intensive care unit (ICU) in a cardiac surgery center and to research the effect of these characteristics on scoring systems used.Method: From 1 September 2014 to 1 September 2019, the study was performed retrospectively with cases admitted to the chronic ICU due to lengthened intensive care requirements after monitoring in the cardiovascular surgery intensive care or coronary ICU. Each case had study forms including information like age, gender, comorbid diseases, acute physiology and chronic health evaluation 2 (APACHE 2) scores, Glasgow Coma scale, the results were statistically assessed.Results: Two hundred and sixty three patients were enrolled for this study. The mean age of patients was 64.6±6 years, with 61% male and 39% female. Of cases, 46% had coronary bypass surgery (n=122), 25% had valve + aorta dissection (n=67), 19% had acute coronary artery (n=51) and 7% had peripheral artery disease (n=17). The mean follow-up duration for patients was identified as 44.2±96.38 days. Cases developing mortality had significantly higher APACHE 2 scores compared to cases without mortality (p<0.05, 24.9±8.0 vs 20.5±7.2). The most common comorbidities in cases were kidney failure in 41% (n=48). Sixty-nine cases had a percutaneous tracheostomy and 21 cases had a surgical tracheostomy, for a total of 90 cases with a tracheostomy.The mortality rate of entire monitored patients during this study period was 42.6%.Conclusion: Very different problems may be encountered in cases observed in the chronic ICU. For these cases, kidney failure is the most Amaç: Bu çalışmada kalp cerrahisi merkezinde, kronik yoğun bakım ünitesinde yatan hastaların klinik ve demografik özelliklerinin değerlendirilmesi ve bu özelliklerin kullanılan skorlama sistemlerine olan etkisinin araştırılması amaçlandı.Yöntem: 1 Eylül 2014-1 Eylül 2019 tarihleri arasında retrospektif olarak kardiyovasküler cerrahi yoğun bakım veya koroner yoğun bakım ünitesinde izlenip yoğun bakım sürecinin uzaması nedeniyle kronik yoğun bakım ünitesine alınan olgularda gerçekleştirildi. Her bir olgunun yaş, cinsiyet, eşlik eden hastalık, Akut Fizyoloji ve Kronik Sağlık Değerlendirmesi 2 (APACHE 2) skorları, Glasgow Koma skalası, bilgileri içeren çalışma formu oluşturuldu. Sonuçlar istatistiksel olarak değerlendirildi.Bulgular: İki yüz altmış üç hasta çalışmaya alınmıştır. Hastaların ortalama yaşları 64,6±6 yıl olup, %61'i erkek %39'u kadındı. Olguların %46'una koroner bypass (n=122) cerrahisi, %25'ine kapak + aort diseksiyonu (n=67) %19 akut koroner arter sonrası (n=51) %7'si periferik arter hastalığı (n=17) sonrası izlenmişti. Hastaların takip süresi ortalama 44,2± 96,38 gün olarak saptanmıştı. Mortalite gelişen olgularda, mortalite gelişmeyen olgulara göre APACHE 2 skoru anlamlı olarak daha yüksekti (p<0,05 24,9±8,0 vs 20,5±7,2). Olgularda en sık gözlenen komorbidite %41 (n=48) Böbrek yetmezliği idi. Altmış dokuz olguya perkutan trakeostomi ve 21 olguya cerrahi tra...

show abstract

Clinical Characteristics and Outcomes of Surgical Patients with Intensive Care Unit Lengths of Stay of 90 Days and Greater

Cited by 13 publications

References 22 publications

Post‐operative intensive care unit admission after elective non‐cardiac surgery: A single‐center analysis of the NSQIP database

Post‐operative intensive care unit admission after elective non‐cardiac surgery: A single‐center analysis of the NSQIP database

Üçüncü Basamak Bir Yoğun Bakım Ünitesinde Bir Yıl Içinde Ölen Hastaların Klinik Özellikleri

Evaluation of Long-term Intensive Care Patients in a Cardiac Surgery Center

Contact Info

Product

Resources

About