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The critically ill patient after hepatobiliary surgery.
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. downeyr@mskcc.org
Critical Care (London, England)
|November 1, 2000
Summary
Hepatobiliary surgery patients requiring special care unit admission faced high mortality, with prolonged stays predicting outcomes. Respiratory failure was the most common complication, but no early predictors were found.
Area of Science:
- Surgery
- Critical Care Medicine
- Gastroenterology
Background:
- Analyzed critical care utilization in post-hepatobiliary surgery patients over 23 months.
- Identified causes and outcomes of special care unit admissions.
Purpose of the Study:
- To investigate the reasons for and outcomes of critical care admissions after hepatobiliary surgery.
- To identify predictors of mortality in this patient population.
Main Methods:
- Retrospective analysis of 537 patients undergoing hepatobiliary surgery.
- Review of special care unit admissions, causes, and mortality data.
- Multivariate analysis to identify predictors of outcome.
Main Results:
- 6.0% (32/537) of patients required special care unit admission.
- Common admission reasons included inability to wean from ventilator, hypovolemic shock, sepsis, and gastrointestinal bleeding.
- Mortality rate for admitted patients was 38% (12/32).
- Prolonged special care unit stay (>4.5 days) was the sole independent predictor of mortality (P=0.041).
Conclusions:
- Respiratory failure was the leading complication post-hepatobiliary surgery.
- No reliable early clinical predictors for patient outcomes were identified.
- Critical care resource utilization in this cohort warrants further investigation.