O088 Is it possible to predict which patients need prolonged intensive care support after elective oesophageal surgery?

Abstract

Abstract Introduction Oesophagectomy for oesophageal cancer is associated with post-operative complications and physiological instability, with cardio-respiratory disturbance in up to 30% of patients. Oesophagectomy patients are regularly admitted to an intensive care unit (ICU) for the first 24 hours after surgery. Increased demand for ICU beds has sparked interest in identifying patients who could be managed in lower intensity environments. We examined pre-operative features potentially associated with increased complication risk. Methods Data from 526 patients who underwent elective oesophagectomy 07/01/2015 - 10/12/2019 was reviewed with basic demographic data available for 485. From 211 patients, data relating to past medical history, American Society of Anesthesiology score (ASA), prescription drug history, and pre-operative blood tests was retrospectively analysed [SPSS v.28; IBM, Chicago] to identify features associated with prolonged ICU stay. Results Median length of post-operative ICU stay was 31 hours. 327 (67.4%) remained on ICU <48 hours, and 158 (32.6%) ≥48 hours. Age >70, ASA ≥3, and female sex were associated with stay ≥48 hours (p=0.044; p=0.036; p<0.001). Increased pre-operative white cell count and serum urea were associated with prolonged ICU stay (p=0.002; p=0.007), as was lower sodium and albumin (p=0.002; p=0.02). Conclusion Predicting which patients are more likely to require prolonged ICU support after oesophagectomy may allow others to be admitted to lower dependency beds. The associations identified could be used in future multivariate analysis to derive a pre-operative scoring system.