Key result
Admission to a recovery high dependency unit for high-risk surgical patients was associated with a 13.0% rate of subsequent ICU admission and a 2.9% in-hospital mortality rate.
Why the study?
Postoperative enhanced care models bridging critical and ward-based care may improve resource efficiency for high-risk surgical patients, prompting the description of an overnight intensive recovery model.
What are the characteristics and outcomes of adult surgical patients admitted to an overnight intensive recovery unit?
Observational (n=1,257)
No
What are the characteristics and outcomes of adult surgical patients admitted to an overnight intensive recovery unit?
An overnight intensive recovery unit for high-risk surgical patients demonstrates a relatively low need for subsequent ICU admission and a very low incidence of medical emergency team calls post-discharge to the ward.
Supports overnight recovery units for high-risk surgical patients; leaves open whether this model improves outcomes versus standard care.
Postoperative 'enhanced care' models that sit between critical care and ward-based care may allow for more cost-effective and efficient utilisation of resources for high-risk surgical patients. In this retrospective observational study, we describe an overnight intensive recovery model in a tertiary hospital, termed 'recovery high dependency unit', and the characteristics, treatment, disposition at discharge and in-hospital outcomes of patients admitted to this unit. We included all adult patients (≥18 years) admitted to the recovery high dependency unit for at least one hour between July 2017 and June 2020. Over this three-year period, 1257 patients were included in the study. The median length of stay in the recovery high dependency unit was 12.6 (interquartile range 9.1-15.9) hours and the median length of hospital stay was 8.3 (interquartile range 5.0-17.3) days. Hospital discharge data showed that 1027 (81.7%) patients were discharged home and that 37 (2.9%) patients died. Non-invasive ventilation was delivered to 59 (4.7%) patients and 290 (23.1%) required vasopressor support. A total of 164 patients (13.0%) were admitted to the intensive care unit following their recovery high dependency unit admission. Of the 1093 patients who were discharged to the ward, 70 patients (6.4%) had a medical emergency team call within 24 hours of discharge from the recovery high dependency unit. In this study of a recovery high dependency unit patient cohort, there was a relatively low need for intensive care unit admission postoperatively and a very low incidence of medical emergency team calls post-discharge to the ward. Other institutions may consider the introduction and evaluation of this model in the care of their higher risk surgical patients.
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Costa‐Pinto et al. (2022) conducted an observational in High-risk surgical patients (n=1,257). Recovery high dependency unit admission was evaluated on Characteristics, treatment, disposition at discharge and in-hospital outcomes. Admission to a recovery high dependency unit for high-risk surgical patients was associated with a 13.0% rate of subsequent ICU admission and a 2.9% in-hospital mortality rate.
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