Early postoperative emergencies requiring an intensive care team intervention. The role of ASA physical status and after-hours surgery.
To examine the risk factors of early postoperative emergencies that required an intensive care team intervention, a matched nested case-control study (34 cases and 126 controls) was conducted. Over a 17-month period, the incidence of early postoperative emergencies occurring within 48 h of surgery was 0.21% (95% confidence intervals (CI): 0.14%-0.30%). The intensive care team treated two cardiac arrests and three respiratory arrests. The major physiological changes which led to ward staff summoning an intensive care team were hypotension (13 cases) and a decreased level of consciousness (nine cases). Significant associations with early postoperative emergencies were high ASA (> or = IV) physical status grades (odds ratio: 4.51, 95% CI: 1.24-16.40) and surgery performed outside normal working hours (odds ratio: 4.40, 95% CI: 1.41-13.69). High-risk patients may benefit from a visit by a postoperative care team during the early postoperative period but this requires further evaluation.
Department of Anaesthetics and Intensive Care, Liverpool Hospital, Australia.
A
A
Lee
M E
ME
Lum
W J
WJ
O'Regan
K M
KM
Hillman
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D003422:Critical Care; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009517:New South Wales; D009551:Night Care; D010348:Patient Care Team; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D011184:Postoperative Period; D012307:Risk Factors; D012720:Severity of Illness Index