Spectrum of postoperative admissions in the intensive care unit of a tertiary care hospital: An Indian update

Abstract

Background: The allocation of intensive care unit (ICU) beds for postoperative patients is a difficult task because of expensive and limited resources. Hence, it is imperative that it requires stratification of patients who most deserve ICU admission. With this background, this study was conducted to do a prospective evaluation of postoperative admissions in the ICU over a period of 1 year to analyze the postoperative admissions to the ICU and to formulate recommendations based on limited resources. Aim: To analyze the postoperative admissions to the ICU and to formulate recommendations based on limited resources. Settings and Design: The study was done in a tertiary level teaching hospital in India, over a period of 1 year. All patients meeting the inclusion criteria admitted to the surgical ICU were analyzed in the study as per method designed. Materials and Methods: Postoperative patients were admitted to ICU into three groups: (1) planned, (2) unplanned, and (3) emergency. The study analyzed American Society of Anesthesiologists (ASA) status, preplanned postoperative ventilation, not reversed due to intraoperative complications (which included those patients who developed intraoperative complications and admitted to ICU for postoperative ventilation), postoperative observation (which included those patients who were admitted to ICU only for monitoring and didn't experience any anticipated perioperative complications) and others causes group. Statistical Analysis: All the statistical analyses were performed using SPSS version 20. Results: In 1 year, total patients operated were 18157 and 261 patients were admitted to ICU. In planned group, maximum patients were ASA III and in unplanned/emergency admissions ASA II. The common cause of postoperative ICU admission in the planned group was postoperative observation (58.80%; 124/211) and in unplanned/emergency group, it was other causes. Maximum patients admitted to ICU were of ASA III (59.40%; 155/261) and for postoperative observation 54.80% (85/155). Conclusions: The authors have a valuable consideration into our standards of anesthetic practice to improve the process of allocating ICU beds for postoperative patient.