Philip Emerson MBChB, BSc , Arthas Flabouris MD, FANZCA, FCICM , Josephine Thomas B.M., B.S, FRACP, PhD , Jeremy Fernando MBChB, FANZCA, FCICM , Siva Senthuran MBBS, FRCA, FCICM, FANZCA , Serena Knowles BN, PhD , Naomi Hammond BN, MPH, PhD , Krish Sundararajan MBBS, MPH, FCICM , with the George Institute of Global Health
{"title":"澳大利亚和新西兰择期手术后的重症监护使用情况:点流行率研究","authors":"Philip Emerson MBChB, BSc , Arthas Flabouris MD, FANZCA, FCICM , Josephine Thomas B.M., B.S, FRACP, PhD , Jeremy Fernando MBChB, FANZCA, FCICM , Siva Senthuran MBBS, FRCA, FCICM, FANZCA , Serena Knowles BN, PhD , Naomi Hammond BN, MPH, PhD , Krish Sundararajan MBBS, MPH, FCICM , with the George Institute of Global Health","doi":"10.1016/j.ccrj.2023.10.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to describe the characteristics, outcomes and resource utilisation of patients being cared for in an ICU after undergoing elective surgery in Australia and New Zealand (ANZ).</p></div><div><h3>Methods</h3><p>This was a point prevalence study involving 51 adult ICUs in ANZ in June 2021. Patients met inclusion criteria if they were being treated in a participating ICU on he study dates. Patients were categorised according to whether they had undergone elective surgery, admitted directly from theatre or unplanned from the ward. Descriptive and comparative analysis was performed according to the source of ICU admission. Resource utilisation was measured by Length of stay, organ support and occupied bed days.</p></div><div><h3>Results</h3><p>712 patients met inclusion criteria, with 172 (24%) have undergone elective surgery. Of these, 136 (19%) were admitted directly to the ICU and 36 (5.1%) were an unplanned admission from the ward. Elective surgical patients occupied 15.8% of the total ICU patient bed days, of which 44.3% were following unplanned admissions. Elective surgical patients who were an unplanned admission from the ward, compared to those admitted directly from theatre, had a higher severity of illness (AP2 17 vs 13, p<0.01), require respiratory or vasopressor support (75% vs 44%, p<0.01) and hospital mortality (16.7% vs 2.2%, p < 0.01).</p></div><div><h3>Conclusions</h3><p>ICU resource utilisation of patients who have undergone elective surgery is substantial. Those patients admitted directly from theatre have good outcomes and low resource utilisation. Patient admitted unplanned from the ward, although fewer, were sicker, more resource intensive and had significantly worse outcomes.</p></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1441277223022214/pdfft?md5=8c3ac9d9a6fc9a882531704c09c851db&pid=1-s2.0-S1441277223022214-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Intensive care utilisation after elective surgery in Australia and New Zealand: A point prevalence study\",\"authors\":\"Philip Emerson MBChB, BSc , Arthas Flabouris MD, FANZCA, FCICM , Josephine Thomas B.M., B.S, FRACP, PhD , Jeremy Fernando MBChB, FANZCA, FCICM , Siva Senthuran MBBS, FRCA, FCICM, FANZCA , Serena Knowles BN, PhD , Naomi Hammond BN, MPH, PhD , Krish Sundararajan MBBS, MPH, FCICM , with the George Institute of Global Health\",\"doi\":\"10.1016/j.ccrj.2023.10.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>We aimed to describe the characteristics, outcomes and resource utilisation of patients being cared for in an ICU after undergoing elective surgery in Australia and New Zealand (ANZ).</p></div><div><h3>Methods</h3><p>This was a point prevalence study involving 51 adult ICUs in ANZ in June 2021. Patients met inclusion criteria if they were being treated in a participating ICU on he study dates. Patients were categorised according to whether they had undergone elective surgery, admitted directly from theatre or unplanned from the ward. Descriptive and comparative analysis was performed according to the source of ICU admission. Resource utilisation was measured by Length of stay, organ support and occupied bed days.</p></div><div><h3>Results</h3><p>712 patients met inclusion criteria, with 172 (24%) have undergone elective surgery. Of these, 136 (19%) were admitted directly to the ICU and 36 (5.1%) were an unplanned admission from the ward. Elective surgical patients occupied 15.8% of the total ICU patient bed days, of which 44.3% were following unplanned admissions. Elective surgical patients who were an unplanned admission from the ward, compared to those admitted directly from theatre, had a higher severity of illness (AP2 17 vs 13, p<0.01), require respiratory or vasopressor support (75% vs 44%, p<0.01) and hospital mortality (16.7% vs 2.2%, p < 0.01).</p></div><div><h3>Conclusions</h3><p>ICU resource utilisation of patients who have undergone elective surgery is substantial. Those patients admitted directly from theatre have good outcomes and low resource utilisation. Patient admitted unplanned from the ward, although fewer, were sicker, more resource intensive and had significantly worse outcomes.</p></div>\",\"PeriodicalId\":49215,\"journal\":{\"name\":\"Critical Care and Resuscitation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1441277223022214/pdfft?md5=8c3ac9d9a6fc9a882531704c09c851db&pid=1-s2.0-S1441277223022214-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical Care and Resuscitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1441277223022214\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care and Resuscitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1441277223022214","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的我们旨在描述澳大利亚和新西兰(ANZ)接受择期手术后在重症监护病房接受治疗的患者的特征、结果和资源利用情况。方法这是一项点流行病学研究,涉及 2021 年 6 月澳大利亚和新西兰的 51 个成人重症监护病房。如果患者在研究日期正在参与研究的重症监护病房接受治疗,则符合纳入标准。根据患者是否接受过择期手术、直接从手术室入院或计划外从病房入院进行分类。根据入住 ICU 的来源进行描述性分析和比较分析。结果 712 名患者符合纳入标准,其中 172 人(24%)接受了择期手术。其中,136人(19%)直接入住重症监护室,36人(5.1%)从病房意外入院。择期手术病人占重症监护病房病人总住院日的 15.8%,其中 44.3%是非计划入院。从病房意外入院的择期手术患者与直接从手术室入院的患者相比,病情严重程度更高(AP2 17 vs 13,p<0.01),需要呼吸或血管加压支持(75% vs 44%,p<0.01),住院死亡率更高(16.7% vs 2.2%,p<0.01)。从手术室直接入院的患者疗效好,资源利用率低。非计划从病房入院的患者虽然人数较少,但病情较重、资源消耗较大、预后明显较差。
Intensive care utilisation after elective surgery in Australia and New Zealand: A point prevalence study
Objective
We aimed to describe the characteristics, outcomes and resource utilisation of patients being cared for in an ICU after undergoing elective surgery in Australia and New Zealand (ANZ).
Methods
This was a point prevalence study involving 51 adult ICUs in ANZ in June 2021. Patients met inclusion criteria if they were being treated in a participating ICU on he study dates. Patients were categorised according to whether they had undergone elective surgery, admitted directly from theatre or unplanned from the ward. Descriptive and comparative analysis was performed according to the source of ICU admission. Resource utilisation was measured by Length of stay, organ support and occupied bed days.
Results
712 patients met inclusion criteria, with 172 (24%) have undergone elective surgery. Of these, 136 (19%) were admitted directly to the ICU and 36 (5.1%) were an unplanned admission from the ward. Elective surgical patients occupied 15.8% of the total ICU patient bed days, of which 44.3% were following unplanned admissions. Elective surgical patients who were an unplanned admission from the ward, compared to those admitted directly from theatre, had a higher severity of illness (AP2 17 vs 13, p<0.01), require respiratory or vasopressor support (75% vs 44%, p<0.01) and hospital mortality (16.7% vs 2.2%, p < 0.01).
Conclusions
ICU resource utilisation of patients who have undergone elective surgery is substantial. Those patients admitted directly from theatre have good outcomes and low resource utilisation. Patient admitted unplanned from the ward, although fewer, were sicker, more resource intensive and had significantly worse outcomes.
期刊介绍:
ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines.
The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world.
The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.