Perioperative medicine & outcomes
Epidemiological Investigation of Unplanned Intensive Care Unit Admissions From the Operating Room After Elective Surgery: A Nationwide Observational Study in Japan
Authors' conclusion
In our review of a nationwide ICU database from 2015 to 2022 we identified a 1.9% rate of unplanned ICU admission and found that mortality varied according to the reasons for ICU admission. Respiratory-related complications were most common, and cardiovascular complications were most associated with in-hospital mortality.
Study context
- Population
- Patients with unplanned ICU admission directly from the OR after elective surgery, Japanese Intensive Care Patient Database, April 2015 to March 2022
- Participants
- 141,969 patients · 2,666 unplanned ICU admissions
- Outcome
- Rate of unplanned ICU admission after elective surgery
Methodological detailsmulticentre, nationwide ICU database (JIPAD)
- Multicentre
- Nationwide ICU database (JIPAD)
Main finding
As reported in the abstract
Unplanned ICU admission after elective surgery
Patients requiring unplanned ICU admission
2666
1.9%
Observational data: associations, not effects.
Further findings
Characteristics of unplanned ICU admissions
- Cardiac arrest before ICU admission
- 52 (2.0%)
- Median APACHE III score
- 51
- Postoperative mechanical ventilation
- 1218 (45.7%)
- Median hospital stay
- 21 days
In-hospital mortality
- In-hospital mortality, all unplanned ICU admissions
- 3.3% (88/2666)
- In-hospital mortality, cardiovascular-related complications (highest)
- 6.8% (20/294)
- Hospital mortality exceeded ICU mortality
Reasons for ICU admission
- Respiratory complications (most common)
- n = 440, 16.5%
- Hemorrhage
- n = 377, 14.1%
Surgery type
- Gastrointestinal neoplasms (most frequent)
- n = 464, 17.4%
- Orthopedic surgeries
- n = 303, 11.4%
- Anaphylaxis occurred across a broad spectrum of surgeries
- Neurological-related complications most frequent in craniotomies for neoplasms
Original publication
Epidemiological Investigation of Unplanned Intensive Care Unit Admissions From the Operating Room After Elective Surgery: A Nationwide Observational Study in Japan. Anesth Analg. Published 5 February 2025. doi:10.
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