ICU sedation, delirium & recovery
The impact of unexpected intensive care unit admission after cancer surgery on long-term symptom burden among older adults: a population-based longitudinal analysis
Main finding · Moderate-to-severe symptom burdenResult — go to the resultRelative risk 1.64 95% CI 1.31–2.05Authors' conclusion
While unexpected ICU admissions are associated with a small increase in the likelihood of experiencing a moderate-to-severe symptom burden, most patients do not experience a high overall symptom burden during the year after surgery.
Study context
- Population
- Older adults (age ≥ 70) who underwent high-intensity cancer surgery and survived to hospital discharge, Ontario, Canada (2007–2017)mean age 76.5 years
- Participants
- 16,560 adults
- Exposure
- Unexpected post-operative intensive care unit (ICU) admission vs no unexpected ICU admission
- Unexpected ICU admissionn = 1,503
- Outcome
- Moderate-to-severe symptom burden (ESAS total symptom score ≥ 40)
- Follow-up
- During the year after surgery
Methodological detailslongitudinal, multivariable-adjusted
- Longitudinal
- Multivariable-adjusted
Main finding
Moderate-to-severe symptom burden
Relative risk
1.64
95% CI 1.31–2.05
Unexpected ICU admission vs No unexpected ICU admission
RR 1.64 (95% CI 1.31–2.05)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted difference (points) | P value |
|---|---|---|
| Adjusted difference in total ESAS score (patients with ≥2 ESAS assessments) · throughout the year10-point difference considered clinically significant | 2.0 to 5.7 | P < 0.001 |
- Adjusted difference in total Edmonton Symptom Assessment System (ESAS) score (patients with ≥2 ESAS assessments): 11,229 (67.8%) patients with multiple ESAS assessments
Average probability of moderate-to-severe symptoms (unexpected ICU admission) · first month after surgery to end of the year
- First month after surgery
- 6.9% (95 CI 5.8-8.3%)
- End of the year
- 3.2% (95% CI 0.9-11.7%)
Original publication
The impact of unexpected intensive care unit admission after cancer surgery on long-term symptom burden among older adults: a population-based longitudinal analysis. Crit Care. Published 25 April 2023. doi:10.
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