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Anaesthesia Critical Care & Pain Medicine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 2 novembre 2018
Doi : 10.1016/j.accpm.2018.09.010
Admission to surgical intensive care unit in time with intensivist coverage and its association with postoperative 30-day mortality: The role of intensivists in a surgical intensive care unit
 

Oh Tak Kyu a, Eunjeong Ji b, Soyeon Ahn c, Dong Jung Kim c, In-Ae Song a,
a Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam 463-707 South Korea 
b Medical Research Collaborating Centre, Seoul National University Bundang Hospital, South Korea 
c Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, South Korea 

Corresponding author.
Abstract
Background

This study aimed to investigate the association between postoperative surgical Intensive Care Unit (ICU) admission during a time when there was intensivist coverage and 30-day mortality after ICU admission.

Methods

This was a retrospective observational study in a tertiary care academic hospital ICU, with daytime intensivist coverage. We collected the electronic medical records for all patients who were admitted to the postoperative ICU after undergoing a surgery between January 1, 2007 and December 31, 2016. The primary outcome was to examine the differences in 30-day mortality after ICU admission according to ICU admission during times of intensivist or non-intensivist coverage.

Results

Overall, 13,906 patients were included (6634 [47.7%] patients were admitted with intensivist coverage, and 7272 [52.3%] patients without intensivist coverage). After performing propensity Score matching, 10,708 patients (5354 patients in each group) were analysed. In the matched cohorts, 30-day mortality after postoperative ICU admission in the group without intensivist coverage was higher than that with intensivist coverage [30-day mortality, 251/5354 (4.7%) and 173/5354 (3.2%) in the groups without and with intensivist coverage, respectively, P  < 0.001]. Post-operative ICU admission in the group without intensivist coverage was associated with an increased risk of 30-day mortality (risk ratio: 1.45, 95% confidence interval: 1.20–1.75, P  < 0.001).

Conclusion

This study showed an increase in post-operative 30-day mortality, and length of hospital and ICU stay for surgical ICU admission among those without intensivist coverage.

The full text of this article is available in PDF format.

Keywords : Intensive care units, Mortality, Time




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