Using predicted 30 day mortality to plan postoperative colorectal surgery care: a cohort study.
Br J Anaesth
; 118(1): 100-104, 2017 Jan.
Article
em En
| MEDLINE
| ID: mdl-28039247
ABSTRACT
BACKGROUND:
Preoperative identification of high-risk surgical patients might help to reduce postoperative morbidity and mortality. Using a patient's predicted 30 day mortality to plan postoperative high-dependency unit (HDU) care after elective colorectal surgery might be associated with reduced postoperative morbidity.METHODS:
The 30 day postoperative mortality was predicted for 504 elective colorectal surgical patients in a preoperative clinic. The prediction was used to determine postoperative surgical ward or HDU care. Those with a predicted 30 day mortality of 1-3% mortality, and thus deemed at intermediate risk, had either planned HDU care (n=68) or planned ward care (n=139). The main outcome measures were emergency laparotomy and unplanned critical care admission.RESULTS:
There were more emergency laparotomies and unplanned critical care admissions in patients with a predicted 30 day mortality of 1-3% who went to an HDU after surgery compared with patients who went to a ward 0 vs 14 (10%), P=0.0056 and 0 vs 22 (16%), P=0.0002, respectively.CONCLUSIONS:
Planned postoperative critical care was associated with a lower rate of complications after elective colorectal surgery.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cuidados Pós-Operatórios
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Reto
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Procedimentos Cirúrgicos do Sistema Digestório
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Mortalidade Hospitalar
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Colo
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Br J Anaesth
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Reino Unido