Key result
Surgery for bronchiectasis, pneumonectomy, and age ≥ 57 years independently predicted effective ICU care need after lung resection, increasing risk from 6% (no predictors) to 93% (all three).
Why the study?
What are the predictive factors for effective use of ICU admission after elective lung resection?
Cohort (n=120)
What are the predictive factors for effective use of ICU admission after elective lung resection?
Absolute Event Rate: 93% vs 6%
Routine ICU admission is not necessary for all patients after lung resection; a risk model using age, pneumonectomy, and surgery for bronchiectasis can predict the need for effective ICU care.
Background. The effective use of ICU care after lung resections has not been completely studied. The aims of this study were to identify predictive factors for effective use of ICU admission after lung resection and to develop a risk composite measure to predict its effective use. Methods. 120 adult patients undergoing elective lung resection were enrolled in an observational prospective cohort study. Preoperative evaluation and intraoperative assessment were recorded. In the postoperative period, patients were stratified into two groups according to the effective and ineffective use of ICU. The use of ICU care was considered effective if a patient experienced one or more of the following: maintenance of controlled ventilation or reintubation; acute respiratory failure; hemodynamic instability or shock; and presence of intraoperative or postanesthesia complications. Results. Thirty patients met the criteria for effective use of ICU care. Logistic regression analysis identified three independent predictors of effective use of ICU care: surgery for bronchiectasis, pneumonectomy, and age ≥ 57 years. In the absence of any predictors the risk of effective need of ICU care was 6%. Risk increased to 25-30%, 66-71%, and 93% with the presence of one, two, or three predictors, respectively. Conclusion. ICU care is not routinely necessary for all patients undergoing lung resection.
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Pinheiro et al. (2016) conducted a cohort in Elective lung resection (n=120). Surgery for bronchiectasis, pneumonectomy, and age ≥ 57 years vs. Absence of these predictors was evaluated on Effective use of ICU care (maintenance of controlled ventilation or reintubation, acute respiratory failure, hemodynamic instability or shock, or intraoperative/postanesthesia complications). Surgery for bronchiectasis, pneumonectomy, and age ≥ 57 years independently predicted effective ICU care need after lung resection, increasing risk from 6% (no predictors) to 93% (all three).
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