TPTh 8.06 Impact of ITU Admissions on CRC Resections: A Cohort Study using INARC (Intensive Care National Audit & Research Centre) Scores

This is the authors' abstract. We don't add key points for this paper.

Aims Postoperative-ITU-support-in-CRC-resections reported <10% (11.9%-readmission & 10%-return-to-theatre: NBOCA-2025), serves critical tool for managing high-risk patients, reducing-mortality, & managing-severe-complications, comes with high-costs-&-resource-implications. Aim of study: review CRC-resections that-received-post-operate-ITU-care (direct & indirect ITU-transfers). Methods Cohort-study of CRC-resections that-received post-operative ITU-care from: -Jan’2007-to-Jan’2026 at single institution. INARC (intensive care national audit & research centre) ITU scores were used. CRC-resections not requiring ITU-care were controls. Results Direct-CRC(n=392) Indirect-CRC(n=76) non-ITU-CRC(n=1525) Kruskall-Wallis(p-value) ANOVA Age(yrs) 74.8±0.6 73.9±1.3 68.8 ± 0.3 <0.0001 Sex(M:F) 233:159 47:29 807:718 NS ASA 3±0.5 2±0.5 2±0 <0.0001 BMI(kg/m2) 27.5±0.3 27.6±0.7 26.3±0.2 <0.005 Laparoscopy(n) 189 38 981 <0.0001 Emergency(n) 131 21 277 < 0.0001 Op-time(mins) 200.1±4.8 170.3±8.8 170.9±2.2 <0.0001 LOS(days) 10±5.5 19±7 7±3.5 <0.0001 90-D-mortality(n) 44 16 59 <0.0001 ITU-stay(days) 2±0.5 4±2.5 Mann-Whitney-U<0.0001 APACHE-II 13.5±0.3 14.1±0.7 NS INARC-score(%) 10.1±0.5 13.1±0.7 <0.0001 INARC-mortality (%) 8.6±0.5 17.5±1.5 < 0.0001 Complications (n) AL 12 11 52 < 0.0001 POI 74 23 218 0.0002 HAP 52 28 122 < 0.0001 SSI’s 41 13 111 0.0022 Sepsis 46 8 66 < 0.0001 Survival Rate(%) 1styear 78.0 72.0 88.1 Logrank 5thyear 48.7 50.3 66.8 p = NS 10thyear 30.4 36.3 51.2 15thyear 15.4 27.1 35.6 Conclusion ITU-support occurred 23.5% CRC-resections: 83.8% direct-ITU & 16.2% indirect-ITU transfers. Factors affecting ITU-transfers: - emergency-surgery, patient-factors (multiple-comorbidity, high-ASA) & complexity-of-surgery (e.g prolonged-operations). ITU-care is limited-resource & costly. There is added benefit of direct-ITU-transfers, thereby reduces indirect-ITU transfers which is-associated with increased mortality & morbidity.