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Article: Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

TitleCritical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries
Authors
Kahan, Brennan C.Koulenti, DesponiaArvaniti, KostoulaBeavis, VanessaCampbell, DouglasChan, MatthewMoreno, RuiPearse, Rupert M.Pearse, Rupert M.Beattie, ScottClavien, Pierre AlainDemartines, NicolasFleisher, Lee A.Grocott, MikeHaddow, JamesHoeft, AndreasHolt, PeterMoreno, RuiPritchard, NaomiRhodes, AndrewWijeysundera, DumindaWilson, MattAhmed, TahaniaEveringham, KirstyHewson, RussellJanuszewska, MartaPearse, Rupert M.Phull, Mandeep KaurHalliwell, RichardShulman, MarkMyles, PaulSchmid, WernerHiesmayr, MichaelWouters, Patrickde Hert, StefanLobo, SuzanaBeattie, ScottWijeysundera, DumindaFang, XiangmingRasmussen, LarsFutier, EmmanuelBiais, MatthieuVenara, AurélienSlim, KaremSander, MichaelKoulenti, DespoinaArvaniti, KostoulaChan, MathewKulkarni, AtulChandra, SusiloTantri, AidaGeddoa, EmadAbbas, MuntadharDella Rocca, GiorgioSivasakthi, DatinMansor, MarzidaLuna, PastorBouwman, ArthurBuhre, WolfgangBeavis, VanessaCampbell, DouglasShort, TimOsinaike, TundeMatos, RicardoGrigoras, IoanaKirov, MikhailProtsenko, DenisBiccard, BruceAldecoa, CesarChew, MichelleHofer, ChristophHubner, MartinDitai, JamesSzakmany, TamasFleisher, LeeFerguson, MarissaMacMahon, MichaelShulman, MarkCherian, RitchieCurrow, HelenKanathiban, KathirgamanathanGillespie, DavidPathmanathan, EdwardPhillips, KatherineReynolds, JeniferRowley, JoanneDouglas, JeaneneKerridge, RossCurrow, HelenGarg, SameerBennett, MichaelJain, MeghaAlcock, DavidTerblanche, NicoCotter, RochelleLeslie, KateStewart, MarcelleZingerle, NicoletteLaw, Cheuk Wah Bassanio
KeywordsSurgical procedures, operative/mortality
Critical care/utilisation
Postoperative care/methods
Postoperative care/statistics and numerical data
Issue Date2017
Citation
Intensive Care Medicine, 2017, v. 43, n. 7, p. 971-979 How to Cite?
Abstract© 2017, Springer-Verlag Berlin Heidelberg and ESICM. 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 [2.10â 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.
Persistent Identifierhttp://hdl.handle.net/10722/244245
ISSN
2023 Impact Factor: 27.1
2023 SCImago Journal Rankings: 6.232
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKahan, Brennan C.-
dc.contributor.authorKoulenti, Desponia-
dc.contributor.authorArvaniti, Kostoula-
dc.contributor.authorBeavis, Vanessa-
dc.contributor.authorCampbell, Douglas-
dc.contributor.authorChan, Matthew-
dc.contributor.authorMoreno, Rui-
dc.contributor.authorPearse, Rupert M.-
dc.contributor.authorPearse, Rupert M.-
dc.contributor.authorBeattie, Scott-
dc.contributor.authorClavien, Pierre Alain-
dc.contributor.authorDemartines, Nicolas-
dc.contributor.authorFleisher, Lee A.-
dc.contributor.authorGrocott, Mike-
dc.contributor.authorHaddow, James-
dc.contributor.authorHoeft, Andreas-
dc.contributor.authorHolt, Peter-
dc.contributor.authorMoreno, Rui-
dc.contributor.authorPritchard, Naomi-
dc.contributor.authorRhodes, Andrew-
dc.contributor.authorWijeysundera, Duminda-
dc.contributor.authorWilson, Matt-
dc.contributor.authorAhmed, Tahania-
dc.contributor.authorEveringham, Kirsty-
dc.contributor.authorHewson, Russell-
dc.contributor.authorJanuszewska, Marta-
dc.contributor.authorPearse, Rupert M.-
dc.contributor.authorPhull, Mandeep Kaur-
dc.contributor.authorHalliwell, Richard-
dc.contributor.authorShulman, Mark-
dc.contributor.authorMyles, Paul-
dc.contributor.authorSchmid, Werner-
dc.contributor.authorHiesmayr, Michael-
dc.contributor.authorWouters, Patrick-
dc.contributor.authorde Hert, Stefan-
dc.contributor.authorLobo, Suzana-
dc.contributor.authorBeattie, Scott-
dc.contributor.authorWijeysundera, Duminda-
dc.contributor.authorFang, Xiangming-
dc.contributor.authorRasmussen, Lars-
dc.contributor.authorFutier, Emmanuel-
dc.contributor.authorBiais, Matthieu-
dc.contributor.authorVenara, Aurélien-
dc.contributor.authorSlim, Karem-
dc.contributor.authorSander, Michael-
dc.contributor.authorKoulenti, Despoina-
dc.contributor.authorArvaniti, Kostoula-
dc.contributor.authorChan, Mathew-
dc.contributor.authorKulkarni, Atul-
dc.contributor.authorChandra, Susilo-
dc.contributor.authorTantri, Aida-
dc.contributor.authorGeddoa, Emad-
dc.contributor.authorAbbas, Muntadhar-
dc.contributor.authorDella Rocca, Giorgio-
dc.contributor.authorSivasakthi, Datin-
dc.contributor.authorMansor, Marzida-
dc.contributor.authorLuna, Pastor-
dc.contributor.authorBouwman, Arthur-
dc.contributor.authorBuhre, Wolfgang-
dc.contributor.authorBeavis, Vanessa-
dc.contributor.authorCampbell, Douglas-
dc.contributor.authorShort, Tim-
dc.contributor.authorOsinaike, Tunde-
dc.contributor.authorMatos, Ricardo-
dc.contributor.authorGrigoras, Ioana-
dc.contributor.authorKirov, Mikhail-
dc.contributor.authorProtsenko, Denis-
dc.contributor.authorBiccard, Bruce-
dc.contributor.authorAldecoa, Cesar-
dc.contributor.authorChew, Michelle-
dc.contributor.authorHofer, Christoph-
dc.contributor.authorHubner, Martin-
dc.contributor.authorDitai, James-
dc.contributor.authorSzakmany, Tamas-
dc.contributor.authorFleisher, Lee-
dc.contributor.authorFerguson, Marissa-
dc.contributor.authorMacMahon, Michael-
dc.contributor.authorShulman, Mark-
dc.contributor.authorCherian, Ritchie-
dc.contributor.authorCurrow, Helen-
dc.contributor.authorKanathiban, Kathirgamanathan-
dc.contributor.authorGillespie, David-
dc.contributor.authorPathmanathan, Edward-
dc.contributor.authorPhillips, Katherine-
dc.contributor.authorReynolds, Jenifer-
dc.contributor.authorRowley, Joanne-
dc.contributor.authorDouglas, Jeanene-
dc.contributor.authorKerridge, Ross-
dc.contributor.authorCurrow, Helen-
dc.contributor.authorGarg, Sameer-
dc.contributor.authorBennett, Michael-
dc.contributor.authorJain, Megha-
dc.contributor.authorAlcock, David-
dc.contributor.authorTerblanche, Nico-
dc.contributor.authorCotter, Rochelle-
dc.contributor.authorLeslie, Kate-
dc.contributor.authorStewart, Marcelle-
dc.contributor.authorZingerle, Nicolette-
dc.contributor.authorLaw, Cheuk Wah Bassanio-
dc.date.accessioned2017-08-31T08:56:27Z-
dc.date.available2017-08-31T08:56:27Z-
dc.date.issued2017-
dc.identifier.citationIntensive Care Medicine, 2017, v. 43, n. 7, p. 971-979-
dc.identifier.issn0342-4642-
dc.identifier.urihttp://hdl.handle.net/10722/244245-
dc.description.abstract© 2017, Springer-Verlag Berlin Heidelberg and ESICM. 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 [2.10â 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.-
dc.languageeng-
dc.relation.ispartofIntensive Care Medicine-
dc.subjectSurgical procedures, operative/mortality-
dc.subjectCritical care/utilisation-
dc.subjectPostoperative care/methods-
dc.subjectPostoperative care/statistics and numerical data-
dc.titleCritical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00134-016-4633-8-
dc.identifier.scopuseid_2-s2.0-85018845020-
dc.identifier.volume43-
dc.identifier.issue7-
dc.identifier.spage971-
dc.identifier.epage979-
dc.identifier.eissn1432-1238-
dc.identifier.isiWOS:000404020100002-
dc.identifier.issnl0342-4642-

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