What is the clinical evidence from this study?

Study design: Cohort. Population: Emergency surgical procedures (n=1984). Intervention: Vasopressor or inotrope use vs. No vasopressor or inotrope use. Primary outcome: Postoperative ICU admission (OR 24.408, 95% CI 6.935-85.909, p=<0.001).

What question did this study set out to answer?

This research aims to identify perioperative factors that predict postoperative ICU admission in patients undergoing emergency surgeries.

April 8, 2026Open Access

Perioperative predictors of critical care admission following emergency surgical procedures: a comprehensive evaluation of anesthesia management

Q: What are the key findings of this study?

Vasopressor or inotrope use was the strongest independent predictor of postoperative ICU admission following emergency surgery, increasing the odds by over 24-fold (OR 24.408).

Q: What question did this study set out to answer?

This research aims to identify perioperative factors that predict postoperative ICU admission in patients undergoing emergency surgeries.

Key Result

Vasopressor or inotrope use was the strongest independent predictor of postoperative ICU admission following emergency surgery, increasing the odds by over 24-fold (OR 24.408).

Key Points

This research aims to identify perioperative factors that predict postoperative ICU admission in patients undergoing emergency surgeries.
Retrospective cohort study design
Included 1,984 patients from a tertiary center
Recorded demographics, trauma status, ASA classification, and anesthesia management practices
Analyzed associations with postoperative ICU admission
Used multivariate analysis to determine independent predictors.
ICU admission rate was 12.1% for emergency surgery patients
Older age and trauma status significantly correlated with higher ICU admissions
Vasopressor or inotrope use and transfusions were linked to increased ICU needs
Multivariate analysis found several strong predictors for ICU admission, including ASA score and age.

Study Design

Type

Cohort (n=1,984)

Multicenter

Structured PICO

What are the independent perioperative predictors of postoperative ICU admission in patients undergoing emergency surgical procedures?

Population

1,984 patients who underwent emergency surgical procedures at a single tertiary center between 2022 and 2023.

Intervention

Evaluation of perioperative factors and anesthesia management

Outcome

Postoperative ICU admission

Advanced age, trauma, elevated ASA status, hemodynamic instability requiring vasopressors/inotropes, and transfusion are strong independent predictors of postoperative ICU admission following emergency surgery.

Main Result

Effect estimate: OR 24.408 (95% CI 6.935-85.909)

p-value: p=<0.001

Limitations

Retrospective design
Possibility of missing data
Potential residual confounding
Single-center nature may limit generalizability
Long-term morbidity and mortality outcomes were not assessed

Abstract

Emergency surgical procedures carry substantial risk, with increased morbidity, mortality, and unplanned intensive care unit (ICU) admissions. Identifying perioperative factors associated with postoperative ICU requirement is essential for improving outcomes and optimizing resource allocation. This study evaluated anesthesia management practices in a large emergency surgery cohort and investigated independent predictors of postoperative ICU admission. This retrospective cohort study included 1,984 patients who underwent emergency surgical procedures at a tertiary center between 2022 and 2023. Demographics, trauma status, ASA classification, airway management, anesthetic technique, hemodynamic support, transfusion, and postoperative analgesia were recorded. The primary endpoint was postoperative ICU admission. The ICU admission rate was 12.1%. ICU-admitted patients were older (57.5 ± 19.1 vs. 36.9 ± 15.2 years, p < 0.001) and more frequently presented with trauma (30.8% vs. 16.0%, p < 0.001). Higher ASA scores, vasopressor or inotrope use (19.9% vs. 0.3%, p < 0.001), and transfusion (32.1% vs. 3.6%, p < 0.001) were strongly associated with ICU need. Multivariate analysis identified age (OR:1.027), trauma (OR:1.606), ASA score (OR:4.376), vasopressor or inotrope use (OR:24.408), and transfusion (OR:4.952) as independently associated factors (all p < 0.05). Specialties showed notable variation in anesthetic technique and postoperative practices. Postoperative ICU requirement in emergency surgery is associated with advanced age, trauma, elevated ASA status, hemodynamic instability, and transfusion. Recognizing these predictors may help inform risk stratification, perioperative planning, and ICU resource utilization. Standardizing anesthesia protocols and strengthening hemodynamic optimization strategies may help inform perioperative risk stratification and ICU resource allocation.

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