Surgical intensive care unit – essential for good outcome in major abdominal surgery?

Linke, Georg R.; Mieth, Markus; Hofer, Stefan; Trierweiler-Hauke, Birgit; Weitz, Jürgen; Martin, Eike; Büchler, Markus W.

doi:10.1007/s00423-011-0758-y

Cited by 10 publications

(7 citation statements)

References 96 publications

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“…The surgical intensivist system, consisting of an ICU staff member with a surgical board, began in 2017 and may also have affected patients’ probability of survival with their knowledge of and experience with ventilator care and vital sign management. The surgical hospitalist’s and surgical intensivist’s close contact with the patients and knowledge of laboratory examination and medical treatment for surgical complications make these systems the most significant recent changes in perioperative care at our department level 38 . Changes in hospital-level also took place during the study period.…”

Section: Discussionmentioning

confidence: 99%

Changes in failure to rescue after gastrectomy at a large-volume center with a 16-year experience in Korea

Park

Kim

Cho

et al. 2023

Sci Rep

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Failure to rescue (FTR), the mortality rate among patients with complications, is gaining attention as a hospital quality indicator. However, comprehensive investigation into FTR has rarely been conducted after radical gastrectomy for gastric cancer patients. This study aimed to assess FTR after radical gastrectomy and investigate the associations between FTR and clinicopathologic factors, operative features, and complication types. From 2006 to 2021, 16,851 gastric cancer patients who underwent gastrectomy were retrospectively analyzed. The incidence and risk factors were analyzed for complications, mortality, and FTR. Seventy-six patients had postoperative mortality among 15,984 patients after exclusion. The overall morbidity rate was 10.49% (1676/15,984 = 10.49%), and the FTR rate was 4.53% (76/1676). Risk factor analysis revealed that older age (reference: < 60; vs. 60–79, adjusted odds ratio [OR] 2.07, 95% confidence interval [CI] 1.13–3.79, P = 0.019; vs. ≥ 80, OR 3.74, 95% CI 1.57–8.91, P = 0.003), high ASA score (vs. 1 or 2, OR 2.79, 95% CI 1.59–4.91, P < 0.001), and serosa exposure in pathologic T stage (vs. T1, OR 2.74, 95% CI 1.51–4.97, P < 0.001) were associated with FTR. Moreover, patients who underwent gastrectomy during 2016–2021 were less likely to die when complications occurred than patients who received the surgery in 2006–2010 (OR 0.35, 95% CI 0.18–0.68, P = 0.002). This investigation of FTR after gastrectomy demonstrated that the risk factors for FTR were old age, high ASA score, serosa exposure, and operation period. FTR varied according to the complication types and the period, even in the same institution.

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Section: Discussionmentioning

confidence: 99%

Changes in failure to rescue after gastrectomy at a large-volume center with a 16-year experience in Korea

Park

Kim

Cho

et al. 2023

Sci Rep

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“…All procedures were carried out according to the standard operating procedure (SOP) of the division of liver surgery 14 , 15 , 16 . The SOP allows individualized decision-making and treatment of patients with liver tumors.…”

Section: Methodsmentioning

confidence: 99%

Surgical management of primary liver cancers during the COVID-19 pandemic: overcoming the dilemma with standardization

Ramouz

Fakour

Jafari

et al. 2023

HPB

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“…Another study evaluated the relationship between nurse-to-patient ratios in the ICU, showing that fewer nurses per patient increase number of postoperative respiratory related complications [ 47 ]. Linke et al [ 48 ] highlighted the role of the surgeon as a leader of a multidisciplinary team in the ICU, not only for his unique knowledge of the patient's anatomy and physiology, but also to make a rapid diagnosis of surgical related complications.…”

Section: Postoperative Patient Managementmentioning

confidence: 99%

Combined Liver and Multivisceral Resections

2014

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Background. Combined liver and multivisceral resections are infrequent procedures, which demand extensive experience and considerable surgical skills. Methods. An electronic search of literature related to this topic published before June 2013 was performed. Results. There is limited scientific evidence of the feasibility and clinical outcomes of these complex procedures. The majority of these cases are simultaneous resections of colorectal tumors with liver metastases. Combined liver and multivisceral resections can be performed with acceptable postoperative morbidity and mortality rates only in carefully selected patients. Conclusion. Lack of experience in these aggressive surgeries justifies a careful selection of patients, considering their comorbidities.

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Surgical intensive care unit – essential for good outcome in major abdominal surgery?

Abstract: Several structures and processes in the ICU have an impact on outcome in major abdominal surgery. ICU structures and care processes connected with optimal outcome could be transmitted to other centers to improve outcome, independent of procedure volume.

Cited by 10 publications

References 96 publications

Changes in failure to rescue after gastrectomy at a large-volume center with a 16-year experience in Korea

Changes in failure to rescue after gastrectomy at a large-volume center with a 16-year experience in Korea

Surgical management of primary liver cancers during the COVID-19 pandemic: overcoming the dilemma with standardization

Combined Liver and Multivisceral Resections

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