The efficacy of intensivist-led closed-system intensive care units in improving outcomes for cancer patients requiring emergent surgical intervention

With the accelerated aging of the population and advancements in medical devices and therapies, there has been a rise in the number of high-risk patients and complex surgical procedures.This trend has underscored the importance of perioperative management and intensive care for severe postoperative complications, reflecting a growing societal demand for these services.Intensive care for critically ill patients necessitates a specialized approach that differs from that for general patients, involving complex pathophysiological considerations and the use of highly specialized, advanced, and costly equipment and interventions [1].Therefore, numerous studies have explored how the organizational efficiency and operational frameworks of intensive care units (ICUs) affect clinical outcomes [2][3][4].Specifically, analyses comparing open ICUs, where primary physicians manage patient care, to closed ICUs, where dedicated intensivists handle all ICU-related care and decision-making, have indicated that closed ICUs are associated with better clinical outcomes, particularly in units treating critically ill patients with high severity of illness.In the closed ICU model, the intensivist-a physician specialized in critical care-takes on comprehensive responsibility for the treatment planning, execution, and operational management of all ICU-admitted patients.The role of the intensivist is therefore central to the effectiveness of the closed ICU system [5][6][7][8].The care of surgical patients requiring ICU admission, particularly those involved in perioperative and postoperative management, necessitates not only a medical approach to underlying conditions but also a deep understanding of the physiological changes and anatomical complexities introduced by surgery.Among these patients, those undergoing emergency surgery for malignancies account for over 60% of all ICU admissions among cancer patients.These individuals often have poor prognoses due to a combination of nutritional deficits, cachexia, general debilitation, organ dysfunction, and the immunosuppressive effects of cancer treatments, which predispose them to severe infectious complications [9].Specifically, intra-abdominal complications following surgery can have a mortality rate as high as 20% [10,11].This highlights the critical importance of specialized medical teams and efficient ICU organizational frameworks in managing the complex pathophysiological changes in these patients.This study compared clinical outcomes between open and closed ICU systems for critically ill patients undergoing emergency surgery due to acute abdominal complications [12].It was found that patients in closed ICUs experienced shorter times from diagnosis to ICU admis-The efficacy of intensivist-led closed-system intensive care units in improving outcomes for cancer patients requiring emergent surgical intervention