Audit of unplanned intensive care unit admissions in elective surgeries
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Abstract
Background: ICU admissions can be planned and unplanned. Unplanned ICU admissions are not anticipated, but intra-operative events determines need of post-operative ICU admission.
Aims and objectives: Study was aimed to audit factors for unplanned ICU admissions of elective surgeries and their ICU course.
Methods: This study was a prospective observational study conducted in a tertiary care hospital over a period of twenty six months. Patients posted for elective surgeries and who were unanticipated for post-operative ICU care were included. Pre-operative and intra-operative indications of admission, course of patients in ICU was monitored and noted.
Results: Total of 9861 elective patients were operated during the study period. 41(0.415%) were shifted to ICU and were unplanned ICU admissions. Mean age was 65±23 years. Majority of patients were in age group 61-70yrs(36.93%). 22 patients were males. 34(83%) patients were ASA II and above. 36.24% patients of unplanned ICU admissions had more than one comorbidity. 24(59%) patients were abdominal surgeries. Main indication of ICU admission was desaturation (31.7%) followed by hemodynamic instability (26.8%). 4.8% patients were shifted to ICU for monitoring. Length of ICU stay was less than 24 hours in 48.78% patients. Mortality was seen in 7 patients (17%). Main cause of mortality was blood loss. ICU infections was cause of mortality in 2 patients. 34 patients recovered during ICU stay.
Conclusion: Unplanned ICU admissions following elective surgery is difficult to predict. Major reason for ICU admission is intraoperative blood loss. Unplanned ICU admission leads to significant death and prolonged hospital stay, reemphasizing preparedness on the part of ICU for unpredictable intra-operative course
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References
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