ICU care after infra-inguinal arterial surgery: an analysis of indications and outcomes

The authors analyzed 632 consecutive, nontrauma Surgical Intensive Care Unit (SICU) admissions after infra-inguinal arterial surgery over a 3-year period (4/89-3/92) for the need for postoperative SICU care. Group I consisted of 122 patients (58 males, 64 females) with at least one absolute indication for SICU care, including mechanical ventilation, pulmonary artery, catheter monitoring, or intravenous infusion of vasoactive or antiarrythmic drugs. Group II comprised 510 patients (275 males, 235 females) without an absolute indication for SICU care. Data collected included age, first day ICU severity of illness scores (Simplified Acute Physiology Score [SAPS] and Quantitative Therapeutic Intervention Scoring System [QTISS]), preoperative length of stay (LOS), SICU LOS, hospital LOS, and mortality. Ten patients (8.2%) in Group I and ten patients (2.0%) in Group II died in the SICU (P = 0.0004). There was no significant difference in the age of Group I and Group II patients, but Group I patients had a significantly longer preoperative LOS (6.1 +/- 0.7 vs 3.2 +/- 0.3 days, P < 0.0005). In Group II patients there were significant correlations between patient age and postoperative death, as well as between preoperative LOS and SICU LOS > 1 day. Patient age > or = 80 years and preoperative LOS > 3 days are significant preoperative correlates of the need for SICU care following infra-inguinal arterial surgery in patients who do not have an absolute indication for such care.