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Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Increased ICU resource needs for an academic emergency general surgery service*
Matthew E Lissauer1, Samuel M Galvagno, Peter Rock
11Department of Surgery and Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD. 2Department of Anesthesiology and Program in Trauma, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD. 3Department of Clinical Effectiveness, University of Maryland Medical Center, Baltimore, MD. 4Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD.
Emergency general surgery patients require more intensive care unit (ICU) resources, including longer stays and higher ventilator and renal replacement therapy usage. These findings highlight a distinct patient population with significant ICU needs.
Area of Science:
- Surgical Critical Care
- Health Services Research
Background:
- Intensive care unit (ICU) needs for nontrauma emergency general surgery (EGS) patients are not well-defined.
- This study aimed to compare ICU resource utilization between EGS patients and other general surgery patient groups.
Purpose of the Study:
- To investigate and compare the ICU resource utilization of emergency general surgery patients admitted to an acute care emergency surgery service versus other general surgery patient cohorts.
- To test the hypothesis that tertiary care EGS patients utilize more ICU resources than other general surgical patients.
Main Methods:
- Retrospective database review of patients aged over 18 admitted to a surgical ICU between March 2004 and June 2012.
- Comparison of ICU length of stay, ventilator usage, and continuous renal replacement therapy (CRRT) usage across different surgical services.
Main Results:
- EGS patients exhibited significantly longer ICU lengths of stay (13.5 days) compared to general surgery (8.7 days) and other groups.
- EGS patients had higher ventilator usage (73.4%) and CRRT usage (10.8%) than other surgical patient groups.
- EGS patients were more frequently interhospital transfers for tertiary care and required emergent surgery.
Conclusions:
- Emergency general surgery patients represent a distinct population with significantly higher ICU resource demands.
- Increased ICU length of stay, ventilator use, and CRRT use in EGS patients may be attributed to higher rates of transfers and emergent surgeries.
- Understanding these unique resource needs is crucial for effective hospital resource allocation and management.
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