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Tissue Engineering by Intrinsic Vascularization in an In Vivo Tissue Engineering Chamber
Published on: May 30, 2016
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Postoperative complications and disposition for vascular surgery.
Andy Jeon1,2, Leena Nagappan1
1Department of Anaesthesia, Pain and Perioperative Medicine, Fiona Stanley Fremantle Hospitals Group, Murdoch, Australia.
Anaesthesia and Intensive Care
|March 29, 2023
Summary
High-risk vascular surgery patients are eight times more likely to require intensive care unit admission and five times more likely to trigger a medical emergency team activation postoperatively. This highlights the need for revised clinical pathways for these vulnerable patients.
Area of Science:
- Surgery
- Intensive Care Medicine
- Patient Outcomes
Background:
- Vascular surgery has a high rate of unplanned intensive care unit admissions.
- Existing postoperative management pathways may not adequately address high-risk vascular surgery patients.
Purpose of the Study:
- To compare postoperative deterioration markers between high-risk and standard-risk vascular surgery patient cohorts.
- To assess the prevalence of medical emergency team activations and unplanned intensive care unit admissions in these cohorts.
Main Methods:
- A single-centre, retrospective cohort study of 680 vascular surgery patients (January-December 2020).
- Patients were risk-stratified using the Surgical Outcome Risk Tool (SORT) into standard-risk (<5% 30-day mortality) and high-risk (≥5% 30-day mortality).
- Outcomes analyzed included unplanned intensive care unit admissions and medical emergency team activations.
Main Results:
- High-risk patients (≥5% SORT risk) were ~8 times more likely to have an unplanned intensive care unit admission (RR 7.65).
- High-risk patients were ~5 times more likely to experience a medical emergency team activation (RR 5.15).
- Overall unplanned intensive care unit admissions were 6.3% and medical emergency team calls were 12.8%.
Conclusions:
- Vascular surgery patients with a SORT risk of 5% or greater experience significantly higher rates of adverse postoperative outcomes.
- Current inpatient management strategies require revision to improve postoperative care for high-risk vascular patients.
- Enhanced postoperative triage is recommended to facilitate early access to higher acuity care for this vulnerable group.
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