Intensive Care Unit Admissions Following Enhanced Recovery After Surgery for Laparoscopic Repair of Perforated Peptic Ulcer

Objective This study aimed to investigate the incidence, causes, and risk factors of intensive care unit (ICU) admission in patients undergoing laparoscopic repair of perforated peptic ulcer (PPU) with enhanced recovery after surgery (ERAS) implementation.Methods A retrospective cohort study included 342 patients undergoing laparoscopic PPU repair with ERAS protocols. Univariable and multivariable logistic regression were used to identify independent risk factors for ICU admission.Results Of 279 included patients, 76 (27.2%) required ICU admission. The causes of admission were respiratory failure (44.7%), circulatory failure (23.7%), surgical complications (10.5%) and others (21.1%). Multivariable analysis revealed that age ≥ 65 years (odds ratio [OR] = 3.63, p = 0.002), ASA physical status III–IV (OR = 3.70, p = 0.002), heart failure (OR = 12.86, p = 0.008), COPD (OR = 16.28, p = 0.003), and kidney failure (OR = 9.42, p = 0.004) were independent risk factors for ICU admission.Conclusions In the context of ERAS protocol implementation, the incidence of ICU admission following laparoscopic repair of PPU was 27.2%, accompanied by a 30-day ICU mortality rate of 6.6%. Among the causes of ICU admission, respiratory failure emerged as the leading factor.