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Observational Study
. 2023 Oct;27(10):2187-2198.
doi: 10.1007/s11605-023-05780-z. Epub 2023 Aug 7.

Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery: Secondary Analysis Of POWER Trial

Alejandro Suárez-de-la-Rica  1   2 , Javier Ripollés-Melchor  3   4 , César Aldecoa  3   5 , Ane Abad-Motos  3   4 , Carlos Ferrando  3   6 , Alfredo Abad-Gurumeta  3   4 , Mariana Díaz-Almirón  7 , Cristina Gil-Lapetra  8 , Francisco Javier García-Miguel  9 , Ana Pedregosa-Sanz  10 , Neus Esteve-Pérez  11 , Rita Rodríguez-Jiménez  12 , Pablo Gimeno Fernandez  13 , Emilio Maseda  14 ; POWER Study Investigators Group for the Spanish Perioperative Audit and Research Network (RedGERM-SPARN)
Collaborators, Affiliations
Observational Study

Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery: Secondary Analysis Of POWER Trial

Alejandro Suárez-de-la-Rica et al. J Gastrointest Surg. 2023 Oct.

Abstract

Background: The efficacy of routine admission of high-risk patients to a critical care unit after surgery is not clear. The aim of our study was to investigate the association between critical care admission after scheduled colorectal surgery and postoperative complications, 30-day mortality, and length of stay in hospital.

Methods: A pre-defined secondary substudy of POWER study was performed. POWER study was a prospective multicenter observational study of patients undergoing elective primary colorectal surgery during a single period of two months of recruitment between September and December 2017.

Results: A total of 2084 patients from 80 Spanish hospitals were included, of which 722 (34.6%) were admitted to critical care unit (CCU) after elective surgery. After adjusting for confounding factors in the multivariate analysis, postoperative CCU admission was independently associated with a higher incidence of moderate-to-severe postoperative complications (adjusted OR 1.951, 95% CI 1.570, 2.425; p < 0.001). Regarding secondary outcomes, postoperative critical care admission was independently associated with higher 30-day mortality (adjusted OR 6.736; 95% CI 2.507, 18.101; p < 0.001) and independently associated with an increased hospital length of stay (adjusted OR 1.143, 95% CI 1.112, 1.175; p < 0.001).

Conclusions: Direct admission to CCU after scheduled colorectal surgery was not associated with a reduction in moderate-to-severe postoperative complications.

Keywords: Colorectal surgery; Intensive care; Perioperative medicine; Postoperative complications.

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References

    1. Weiser TG, Haynes AB, Molina G et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet. 2015 Apr 27;385 Suppl 2:S11. https://doi.org/10.1016/S0140-6736(15)60806-6 . - DOI - PubMed
    1. Gillies MA, Sander M, Shaw A et al. Current research priorities in perioperative intensive care medicine. Intensive Care Med. 2017;43(9):1173-1186. https://doi.org/10.1007/s00134-017-4848-3 . - DOI - PubMed
    1. Fowler AJ, Abbott TEF, Prowle J, Pearse RM. Age of patients undergoing surgery. Br J Surg. 2019;106(8):1012-1018. https://doi.org/10.1002/bjs.11148 . - DOI - PubMed
    1. Pearse RM, Holt PJ, Grocott MP. Managing perioperative risk in-patients undergoing elective non-cardiac surgery. BMJ. 2011;343:d5759. https://doi.org/10.1136/bmj.d5759 .
    1. Pearse RM, Harrison DA, James P et al. Identification and characterisation of the high-risk surgical population in the United Kingdom. Crit Care. 2006;10(3):R81. https://doi.org/10.1186/cc4928 . - DOI - PubMed - PMC

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