Your browser doesn't support javascript.
loading
Surgical High Dependency Admissions after Elective Laparoscopic Colorectal Resections: Is It Truly Necessary?
Tan, Jarrod K H; Koh, Wei-Ling; Peh, Cherie Hui; Lee, Ailica W X; Lau, Jerrald; Chee, Corissa; Tan, Ker-Kan.
Afiliación
  • Tan JKH; Department of Surgery, National University Hospital, Singapore.
  • Koh WL; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Peh CH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Lee AWX; Department of Surgery, National University Hospital, Singapore.
  • Lau J; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Chee C; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
  • Tan KK; Department of Surgery, National University Hospital, Singapore.
J Intensive Care Med ; 39(2): 153-158, 2024 Feb.
Article en En | MEDLINE | ID: mdl-37583284
ABSTRACT

BACKGROUND:

Surgical high dependency (SHD) allows for intermediate care provision between general ward (GW) and intensive care unit (ICU) for surgical patients but no universally accepted admission criteria exists. Unnecessary SHD admissions should be minimized to limit resource wastage and maintain spare critical care capacity. This study evaluates the utility of SHD admissions following elective laparoscopic colectomy by comparing post-operative outcomes and interventions performed between SHD and GW patients.

METHODOLOGY:

A retrospective review of all colorectal cancer patients who underwent elective laparoscopic colectomy in our institution between January 2019 and December 2021 was conducted. Patients converted to open surgery or admitted to IC post-operatively were excluded. Peri-operative parameters and outcomes between patients admitted to GW and SHD post-operatively were evaluated.

RESULTS:

The cohort comprised 393 patients. There were 153 patients (38.93%) who required SHD admission. SHD patients had higher American Society of Anesthesiology (ASA) scores, body mass index, age and intra-operative blood loss. Majority of post-operative morbidity were minor (Clavien-Dindo II or lower) in both groups and the interventions required were safely instituted in both SHD and GW. None of the patients in the cohort required inotropic or ventilatory support in the SHD.

CONCLUSIONS:

GW patients were "healthier" but post-operative morbidity and interventions required were similar to the SHD group. Nonetheless, treatment delays, absence of continuous monitoring, and decreased nurse-to-patient ratio may be significant for patients with limited physiological reserves. Further studies should evaluate safety and cost-effectiveness of managing high risk surgical patients in GW using continuous remote vital signs monitoring.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Laparoscopía Límite: Humans Idioma: En Revista: J Intensive Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article País de afiliación: Singapur

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Laparoscopía Límite: Humans Idioma: En Revista: J Intensive Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article País de afiliación: Singapur