Abstract
Immediate postoperative intensive care unit (ICU) admission can increase the survival rate in patients undergoing high-risk surgeries. Nevertheless, less than 15% of such patients are immediately admitted to the ICU due to no reliable criteria for admission. The surgical Apgar score (SAS) (0–10) can be used to predict postoperative complications, mortality rates, and ICU admission after high-risk intra-abdominal surgery. Our study was performed to determine the relationship between the SAS and postoperative ICU transfer after all surgeries. All patients undergoing operative anesthesia were retrospectively enrolled. Among 13,139 patients, 68.4% and < 9% of whom had a SASs of 7–10 and 0–4. Patients transferred to the ICU immediately after surgery was 7.8%. Age, sex, American Society of Anesthesiologists (ASA) class, emergency surgery, and the SAS were associated with ICU admission. The odds ratios for ICU admission in patients with SASs of 0–2, 3–4, and 5–6 were 5.2, 2.26, and 1.73, respectively (P < 0.001). In general, a higher ASA classification and a lower SAS were associated with higher rates of postoperative ICU admission after all surgeries. Although the SAS is calculated intraoperatively, it is a powerful tool for clinical decision-making regarding the immediate postoperative ICU transfer.
Highlights
In Taiwan, more than 14.9 million patients underwent surgery in 2015, including 4.6 million who underwent in-hospital surgeries[1]
Due to its ability to predict postoperative complications and mortality, the surgical Apgar score (SAS) might be useful for the prediction of postoperative intensive care unit (ICU) admission
Our study demonstrated that the SAS was strongly associated with postoperative ICU transfer after all surgeries
Summary
In Taiwan, more than 14.9 million patients underwent surgery in 2015, including 4.6 million who underwent in-hospital surgeries[1]. Previous studies have shown that patients undergoing high-risk surgeries account for more than 80% of postoperative deaths; less than 15% were admitted to the intensive care unit (ICU) immediately after the operation[2]. Patients who received intensive care immediately following the operation had a lower level of morbidity[3]. Due to its ability to predict postoperative complications and mortality, the SAS is considered a potential tool for the prediction of postoperative ICU admission. Previous studies have concluded that the SAS is correlated with ICU admission after high-risk intra-abdominal surgery[26] and general surgery[27]. Its ability to predict ICU admission after other operations remains unknown. This study was performed to determine the relationship between the SAS and postoperative ICU transfer after all surgeries
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