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Published on: September 6, 2024
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Audit of Postoperative Surgical Intensive Care Unit Admissions
Shaili K Patel1, Samir M Kacheriwala1, Dipesh D Duttaroy1
1Department of Surgery, Medical College Baroda, Sir Sayajirao General Hospital, Vadodara, Gujarat, India.
Summary
This audit identified key risk factors for Surgical Intensive Care Unit (SICU) admissions, revealing higher mortality in elderly males and those with prolonged SICU stays.
Area of Science:
- Critical Care Medicine
- Surgical Outcomes
- Hospital Auditing
Background:
- Postoperative patient outcomes in Surgical Intensive Care Units (SICUs) require careful evaluation.
- Identifying admission risk factors is crucial for optimizing critical care resource allocation.
- Understanding predictors of mortality aids in improving patient management strategies.
Purpose of the Study:
- To audit Surgical Intensive Care Unit (SICU) admissions.
- To identify risk factors associated with postoperative patient admissions.
- To evaluate the outcomes of patients admitted to the SICU.
Main Methods:
- Prospective, observational study design.
- Conducted at a tertiary care university hospital in Western India.
- Included 240 postoperative patients admitted to the SICU over 15 months.
Main Results:
- Planned SICU admission rate was 4.45%; unplanned rate was 0.09%.
- Advanced age, male gender, high surgical risk (ASA/ACC/AHA), emergency surgery, and planned admissions correlated with higher mortality.
- Mortality was significantly higher in patients with SICU stays exceeding 7 days (75.86%) and readmitted cases (72.73%).
Conclusions:
- Postoperative critical care needs are elevated in males, the elderly, and patients with poor risk scores or specific surgical types (abdominal, trauma, emergent).
- Preexisting medical conditions, intraoperative hemorrhage, and hypotension requiring inotropic support increase critical care demand.
- Further research across diverse surgical subspecialties is recommended for refined SICU admission decision-making.
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