Publication
Critical Care Admission Following Elective Surgery Was Not Associated With Survival Benefit: Prospective Analysis of Data From 27 Countries
| dc.contributor.author | Kahan, BC | |
| dc.contributor.author | Koulenti, D | |
| dc.contributor.author | Arvaniti, K | |
| dc.contributor.author | Beavis, V | |
| dc.contributor.author | Campbell, D | |
| dc.contributor.author | Chan, M | |
| dc.contributor.author | Moreno, R | |
| dc.contributor.author | Pearse, RM | |
| dc.date.accessioned | 2018-01-31T16:42:48Z | |
| dc.date.available | 2018-01-31T16:42:48Z | |
| dc.date.issued | 2017-07 | |
| dc.description.abstract | PURPOSE: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. METHODS: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests. RESULTS: 44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10-5.21]; p < 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings. CONCLUSIONS: We did not identify any survival benefit from critical care admission following surgery. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Intensive Care Med. 2017 Jul;43(7):971-979. | pt_PT |
| dc.identifier.doi | 10.1007/s00134-016-4633-8 | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/2877 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Springer Verlag | pt_PT |
| dc.subject | HSJ UCI | pt_PT |
| dc.subject | Elective Surgical Procedures/mortality | pt_PT |
| dc.subject | Elective Surgical Procedures/statistics & numerical data | pt_PT |
| dc.subject | Hospitalization/statistics & numerical data | pt_PT |
| dc.subject | Intensive Care Units/statistics & numerical data | pt_PT |
| dc.subject | Length of Stay/statistics & numerical data | |
| dc.subject | Logistic Models | |
| dc.subject | Perioperative Care/methods | |
| dc.subject | Postoperative Period | |
| dc.subject | Prospective Studies | |
| dc.title | Critical Care Admission Following Elective Surgery Was Not Associated With Survival Benefit: Prospective Analysis of Data From 27 Countries | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 979 | pt_PT |
| oaire.citation.issue | 7 | pt_PT |
| oaire.citation.startPage | 971 | pt_PT |
| oaire.citation.title | Intensive Care Medicine | pt_PT |
| oaire.citation.volume | 43 | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |