Abstract
Background The aim of this study was to evaluate the influence of prolonged length of stay in an intensive care unit (ICU) on the mortality and morbidity of surgical patients. Methods We performed a monocentric and retrospective observational study in the surgical critical care unit of the department of surgery at the Medical Center of the University of Freiburg, Germany. Clinical data was collected from patients assigned to the ICU with a length of stay (LOS) of 90 days and greater. Results From the total of the 19 patients with ICU LOS over 90 days, ten patients died in the ICU whereas nine patients were discharged to the normal ward. The ICU mortality rate was 52%. The overall survival one year after ICU discharge was 32%. Regarding factors affecting mortality of the patients, significantly higher mortality was associated with age of the patients at the time point of the ICU admission and with postoperative need of renal replacement therapy. Conclusions We found a high but in our opinion acceptable mortality rate in surgical patients with ICU LOS of 90 days and greater. We identified age and the need of renal replacement therapy as risk factors for mortality.
Highlights
Intensive care for patients after major abdominal surgery is nowadays a fixed component of postoperative pathways
Ten patients (52%) suffered postoperatively from acute renal failure and 7 patients (31.5%) were in need for dialysis. The goal of this retrospective study was to evaluate a small group of patients with extremely long surgical ICU (SICU) stay, to investigate their characteristics, and to identify risk factors correlating to higher mortality rates
Despite the fact that the performance of complex operative procedures on multimorbid patients has led to an increase of the ICU length of stay (LOS) in individual patients, we know little about the outcome of patients with a very long stay in an intensive care unit
Summary
Intensive care for patients after major abdominal surgery is nowadays a fixed component of postoperative pathways. The majority of patients after abdominal surgery requires only a few days of intensive care unit (ICU) care, but performing complex operative procedures on older and multimorbid patients has led to an increase in the demand for critical care services and to an increase in the postoperative ICU length of stay (LOS) in individual patients [1,2,3]. Regarding surgical ICU (SICU) patients, the definition of prolonged ICU LOS ranges between 7 and 21 days [7,8,9]. The aim of this study was to evaluate the influence of prolonged length of stay in an intensive care unit (ICU) on the mortality and morbidity of surgical patients. We found a high but in our opinion acceptable mortality rate in surgical patients with ICU LOS of 90 days and greater. We identified age and the need of renal replacement therapy as risk factors for mortality
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