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KMID : 0604020150300010001
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Korean Journal of Critical Care Medicine
2015 Volume.30 No. 1 p.1 ~ p.7
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Clinical Outcome and Prognosis of Patients Admitted to the Surgical ICU after Abdomen Surgery
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Sim Yun-Su
Lee Jin-Hwa
Chang Jung-Hyun
Ryu Yon-Ju
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Abstract
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Background: Postoperative admission to the surgical intensive care unit (S-ICU) is commonly planned to prevent and treat complications,unnecessary admission to the S-ICU increases medical costs and length of hospital stay. This study aimed evaluated outcomeand the predictive factors for mortality in patients admitted to the S-ICU after abdominal surgery.
Methods: The 168 patients admitted to the S-ICU immediately after abdominal surgery were reviewed retrospectively from Januaryto December 2011.
Results: The mortality rate of patients admitted to the S-ICU after abdominal surgery was 8.9% (15 of 168). Two preoperative factors(body mass index [BMI] < 18.5 kg/m2 [p < 0.001] and serum albumin < 3.0 g/dL [p = 0.018]), two operative factors (the need for transfusion[p = 0.008] or vasopressors [p = 0.013] during surgery), and three postoperative variables (mechanical ventilation immediatelyfollowing surgery [p < 0.001], sequential organ failure assessment [p = 0.001] and SAPS II [p = 0.001] score) were associated with mortalityin univariate analysis. After adjusting for age, gender, and SAPS II by a Cox regression, which revealed that BMI < 18.5 kg/m2 (p <0.001, hazard ratio [HR] 9.690, 95% confidence interval [CI] 2.990-25.258) and the use of mechanical ventilation on admission to S-ICU (p< 0.001, HR 34.671, 95% CI 6.440-186.649) were independent prognostic factors.
Conclusions: In patients in S-ICU after abdominal surgery, low BMI and postsurgical mechanical ventilation should be considered importantpredictors of mortality.
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KEYWORD
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body mass index, intensive care units, postoperative complications, surgery
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