POSTOPERATIVE OUTCOME OF PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT AFTER ELECTIVE AND EMERGENCY LAPAROTOMY

Area of Science:

• Surgery
• Intensive Care Medicine
• Epidemiology

Background:

• Abdominal surgery carries significant risks of morbidity and mortality, especially for critically ill patients requiring intensive care unit (ICU) admission.
• Identifying factors influencing outcomes is crucial for improving patient care and resource allocation in surgical ICUs.

Purpose of the Study:

• To determine the risk factors associated with adverse outcomes in a large cohort of patients admitted to a surgical ICU following abdominal surgery.
• To analyze the correlation between various clinical and perioperative variables and in-hospital mortality.

Main Methods:

• Retrospective evaluation of 1,717 patients admitted to a surgical ICU between January 2016 and December 2022.
• Comparison of demographic, clinical, and perioperative data with in-hospital mortality rates.
• Utilized Charlson Comorbidity Index (CCI) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores to assess patient severity.

Main Results:

• Overall in-hospital mortality was 9.2% (158 patients).
• Univariate analysis showed age, CCI, surgery type (emergent/urgent vs. elective), and APACHE II score were associated with mortality.
• Multivariate analysis identified CCI, surgery type, and APACHE II score as independent predictors of mortality.

Conclusions:

• Current in-hospital mortality after abdominal surgery requiring ICU support is below 10%.
• Urgent or emergent surgeries, greater disease severity (APACHE II), and higher comorbidity burden (CCI) are independently linked to increased mortality risk.
• These findings highlight key areas for intervention to reduce adverse outcomes in this patient population.