Appropriate triage of high-risk non-cardiac surgical patients to intensive care using objective scoring systems and goal-directed therapy may improve postoperative outcomes.
May support selective ICU triage for high-risk non-cardiac surgery patients; leaves open need for randomized validation.
Patients who undergo high-risk non-cardiac surgical procedures represent a large proportion of admissions to intensive care units (ICUs) in the developed world [ 1 ]. Ideally, surgeons, anesthesiologists, and intensivists admitting surgical patients to ICUs target the patients who will benefit most from this highest level of post-operative care. However, accurately identifying which patients are at high risk of complications or death after major surgery remains difficult. For example, a recent study in the United Kingdom demonstrated that patients undergoing high-risk general surgical procedures comprised only 12.5% of surgical admissions to hospitals but over 80% of deaths, with less than 15% of these high-risk patients admitted to the ICU postoperatively [ 2 ].
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Sobol et al. (2011) studied this question.