Key result
In noncardiac surgical patients admitted to the ICU, the overall hospital mortality was 7.9%, and admission APACHE-II score, sepsis, and acute kidney injury were independent predictors for mortality.
Why the study?
What is the incidence and what are the risk factors for postoperative complications and mortality in noncardiac surgical patients admitted to the ICU?
Observational (n=762)
No
What is the incidence and what are the risk factors for postoperative complications and mortality in noncardiac surgical patients admitted to the ICU?
Patients admitted to the ICU following noncardiac surgery have high rates of complications (51.4%) and hospital mortality (7.9%), primarily driven by high illness severity scores, sepsis, and acute kidney injury.
Mortality predictors in noncardiac surgical ICU patients warrant attention; leaves open whether targeting them improves outcomes.
CONTEXT: Surgical procedures carry significant morbidity and mortality depending on the type of surgery and patients. There is a dearth of evidence from India on the outcome of surgical patients admitted to an Intensive Care Unit (ICU). AIMS: We aimed to describe the incidence and risk factors of postoperative complications and mortality in noncardiac surgical patients admitted to the ICU. SETTINGS AND DESIGN: This was a prospective observational study on all perioperative patients admitted to a multidisciplinary ICU for 18 months. SUBJECTS AND METHODS: Data on demography, admission Acute Physiology and Chronic Health Evaluation II (APACHE-II), Sequential Organ Failure Assessment (SOFA) scores, perioperative course, type and duration of surgery, reason for ICU admission, ICU interventions, and perioperative complications were recorded. The primary outcomes analyzed were perioperative complications and mortality. Common complications observed were hemodynamic instability 24%, hypothermia 17.2%, sepsis 17.3%, poor glycemic control 11.2%, perioperative myocardial infarction 7.1%, cardiac arrest 0.13%, and acute kidney injury (AKI) 10.1%. The overall hospital mortality was 7.9%. Multivariate logistic regression analysis showed that admission APACHE-II score, sepsis, AKI, and ICU length of stay were independent predictors for mortality. CONCLUSIONS: High risk perioperative patients after noncardiac surgery have significant mortality and morbidity.
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Renuka et al. (2017) conducted an observational in High-risk noncardiac surgical patients (n=762). Noncardiac surgery requiring ICU admission was evaluated on Hospital mortality. In noncardiac surgical patients admitted to the ICU, the overall hospital mortality was 7.9%, and admission APACHE-II score, sepsis, and acute kidney injury were independent predictors for mortality.
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