Key result
Orthopedic inpatient surgery links to a ~2% critical care admission rate, peaking in spine patients.
Why the study?
Data on the use of critical care services in patients undergoing orthopedic procedures remain sparse despite orthopedics being a large and fast-growing surgical field.
Observational (n=50,387)
No
Approximately one-fourth of orthopedic surgery patients require critical or intermediate levels of care, highlighting significant resource allocation needs, particularly for spine surgery patients.
Orthopedic inpatients, especially spine, often need step-down or critical care; supports resource planning but leaves open predictive modeling for targeted use.
Background: With an aging population, orthopedics has become one of the largest and fastest growing surgical fields. However, data on the use of critical care services (CCS) in patients undergoing orthopedic procedures remain sparse. Purpose: We sought to elucidate the prevalence and characteristics of patients requiring CCS and intermediate levels of care after orthopedic surgeries at a high-volume orthopedic medical center. Methods: We retrospectively reviewed inpatient electronic medical record data (2016–2020) at a high-volume orthopedic hospital. Patients who required CCS and intermediate levels of care, including step-down unit (SDU) and telemetry services, were identified. We described characteristics related to patients, procedures, and outcomes, including type of advanced services required and surgery type. Results: Of the 50,387 patients who underwent orthopedic inpatient surgery, 1.6% required CCS and 21.6% were admitted to an SDU. Additionally, 482 (1.0%) patients required postoperative mechanical ventilation and 3602 (7.1%) patients required continuous positive airway pressure therapy. Spine surgery patients were the most likely to require any form of advanced care (45.7%). Conclusions: This retrospective review found that approximately one-fourth of orthopedic surgery patients were admitted to units that provided critical and intermediate levels of care. These results may prove useful to hospitals in estimating needs and allocating resources for advanced and critical care services after orthopedic surgery.
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Zhong et al. (2021) conducted an observational in Orthopedic surgery (n=50,387). Orthopedic surgery was evaluated on Requirement of critical care services (CCS). Orthopedic inpatient surgery resulted in 1.6% of patients requiring critical care services and 21.6% requiring step-down unit admission, with spine surgery patients having the highest need (45.7%).
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