Key result
Lack of postoperative ICU access is linked to ~3-fold higher 30-day surgical mortality.
Why the study?
There is a paucity of published data on outcomes of critically ill acute care surgery patients who lacked ICU access after surgery in resource-limited countries.
Does timely ICU admission improve mortality and length of hospital stay in acute care surgery patients with criteria for post-operative ICU admission?
Cohort (n=213)
Yes
Does timely ICU admission improve mortality and length of hospital stay in acute care surgery patients with criteria for post-operative ICU admission?
Timely ICU admission is associated with significantly lower mortality compared to delayed or no ICU admission in acute care surgery patients requiring post-operative intensive care.
Answers are grounded in this paper and cite their sources.
May warrant prioritizing ICU access for high-risk acute surgery patients; leaves open causal benefit in prospective trials.
Background: Lack of access to intensive care unit (ICU) for both surgical and non-surgical patients is common in countries with limited resources. In the current literature, there is a paucity of published data on the outcome of critically ill patients who lacked ICU access after surgery. The aim of this study was to assess the mortality and length of hospital stay for operated acute care surgery (ACS) patientswith criteria of post-operative ICU admission. Methods:This was prospective cohort study conducted on ACS patients with pre-operative criteria of ICU admission in two Rwandan university teaching hospitals. The patients were followed from admission until discharge or 30 days in-hospital. We documented basic characteristics, diagnosis, length of hospital stay and mortality. We compared mortality and length of stay in hospital for patients with timely admission, delayed admission, and patients not admitted to the ICU. Data was collected, electronically captured and analyzed using SPSS software. Results: 213 ACS patients enrolled in this study. The rate of post-operative ICU access was 38.5% (n=82) with 53 (24.9%) patients with timely ICU admission and 29 (13.6%) with delayed ICU admission. The remaining 131 (61.5%) patients were not admitted to the ICU. Mortality rate among patients with timely ICU admission was 26.4% versus 89.7% for delayed admission and 48.1% in patients with no ICU admission (p-value <0.001). The hospital-stay for timely ICU admission was 13.7 days versus 7.1 days in patients who had delayed ICU admission and 16.5 days for patients with no ICU admission (p-value <0.001). Conclusion: This study showed high mortality of ACS patients who underwent surgery with criteria to be admitted in ICU postoperatively. Increasing ICU access has the potential to improve patient outcomes.
No takes yet. Share an insight, caveat, or question.
Manirabona et al. (2023) conducted a cohort in Acute care surgery requiring post-operative ICU admission (n=213). Lack of intensive care unit (ICU) access vs. Timely ICU admission (≤ 6 hours) was evaluated on 30-day in-hospital mortality (OR 3, 95% CI 1.281-5.199, p=<0.001). Lack of post-operative ICU access in critically ill acute care surgery patients was associated with a 3-fold increased odds of 30-day mortality compared to timely ICU admission.
Synapse has enriched 8 closely related papers on similar clinical questions. Consider them for comparative context: