Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Dec;6(1):42.
doi: 10.1186/s13613-016-0129-5. Epub 2016 Apr 30.

SAPS 3 score as a predictive factor for postoperative referral to intensive care unit

João M Silva Jr  1   2 , Helder Marcus Costa Rocha  3 , Henrique Tadashi Katayama  3 , Leandro Ferreira Dias  3 , Mateus Barros de Paula  3 , Leusi Magda Romano Andraus  3 , Jose Maria Correa Silva  3 , Luiz Marcelo Sá Malbouisson  3   4
Affiliations

SAPS 3 score as a predictive factor for postoperative referral to intensive care unit

João M Silva Jr et al. Ann Intensive Care. 2016 Dec.

Erratum in

Abstract

Background: Patients undergoing intermediate-risk surgery are typically taken to the ward postoperatively. However, some may develop complications requiring intensive care later. We aimed to evaluate the characteristics of patients undergoing intermediate-risk surgery who required late postoperative admission to the intensive care unit (ICU) and determine the predictors for this.

Methods: The study included patients undergoing intermediate-risk surgery with preoperative indication for ICU but who were taken to the ward postoperatively, because they appeared to be responding well. However, they required late ICU admission. ICU care and preoperative SAPS 3 score were evaluated. Palliative surgeries and patients readmitted to ICU were excluded.

Results: The study included 100 patients, 27 % of whom had late postoperative admission to the ICU. The preoperative SAPS 3 score was higher (45.4 ± 7.8 vs. 35.9 ± 7.4, P < 0.001) in patients who required delayed admission to the ICU postoperatively. Furthermore, they had undergone longer surgery (4.2 ± 1.9 vs. 2.7 ± 1.5 h, P < 0.001), and a greater proportion were gastrointestinal surgeries (14.8 vs. 5.5 %, P = 0.03) and intraoperative transfusion (18.5 vs. 5.5 % P = 0.04). In multivariate analysis, preoperative SAPS 3 and surgery duration independently predicted postoperative ICU admission, respectively (OR 1.25; 95 % CI 1.1-1.4 and OR 3.33; 95 % CI 1.7-6.3).

Conclusion: The identification of high-risk surgical patients is essential for proper treatment; time of surgery and preoperative SAPS 3 seem to provide a useful indication of risk and may help better to characterize patients undergoing intermediate-risk surgery that demand ICU care.

Keywords: Criteria; Intensive care unit; Risk; Surgical patients.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow chart of the number of patients screened
Fig. 2
Fig. 2
ROC curves of surgery time and SAPS 3 score for ICU referral
Fig. 3
Fig. 3
SAPS 3 score stratification and ICU referral rate
See this image and copyright information in PMC

References

    1. Silva JM, Jr, Oliveira AM, Segura JL, Ribeiro MH, Sposito CN, Toledo DO, Rezende E, Malbouisson LM. A large venous-arterial PCO(2) is associated with poor outcomes in surgical patients. Anesthesiol Res Pract. 2011;2011:759792. - PMC - PubMed
    1. Caldeira VM, Silva Junior JM, Oliveira AM, Rezende S, Araujo LA, Santana MR, Amendola CP, Rezende E. Criteria for patient admission to an intensive care unit and related mortality rates. Rev Assoc Med Bras. 2010;56(5):528–534. doi: 10.1590/S0104-42302010000500012. - DOI - PubMed
    1. Jhanji S, Thomas B, Ely A, Watson D, Hinds CJ, Pearse RM. Mortality and utilisation of critical care resources amongst high-risk surgical patients in a large NHS trust. Anaesthesia. 2008;63(7):695–700. doi: 10.1111/j.1365-2044.2008.05560.x. - DOI - PubMed
    1. Simchen E, Sprung CL, Galai N, Zitser-Gurevich Y, Bar-Lavi Y, Gurman G, Klein M, Lev A, Levi L, Zveibil F, et al. Survival of critically ill patients hospitalized in and out of intensive care units under paucity of intensive care unit beds. Crit Care Med. 2004;32(8):1654–1661. doi: 10.1097/01.CCM.0000133021.22188.35. - DOI - PubMed
    1. Anonymous. Guidelines for developing admission and discharge policies for the pediatric intensive care unit. Pediatric Section Task Force on Admission and Discharge Criteria, Society of Critical Care Medicine in conjunction with the American College of Critical Care Medicine and the Committee on Hospital Care of the American Academy of Pediatrics. Crit Care Med. 1999;27(4):843–5. - PubMed

LinkOut - more resources