[Patient assignment to a surgical intensive care unit - plea for a preoperative risk stratification].
BACKGROUND
Surgical intensive care units (ICUs) have to meet the demands of caring for elective surgical patients, for surgical emergencies, and for trauma patients. To achieve this a high flexibility and a high rate of admissions and discharges are needed. ICU beds are scant and expensive, so who is to be admitted?


METHODS
All admissions and dis-charges of a 20-bed surgical ICU in a university hospital within one year have been analysed.


RESULTS
During the analysed year 2524 patients were admitted to the surgical ICU (6.9 + or - 3.1 per day). Of 1886 planned admissions (elective surgery) only 1234 were eventually admitted, but there were 1290 additional patients admitted as emergencies. Of all realised admissions only 49 % were planned. In 653 requested but refused elective admissions, the surgery was performed with-out intensive care admission in 432 patients (64.9 %).


CONCLUSIONS
Half of the patients of the surgical ICU are electively surgical, half of them are emergencies. The limited number of ICU beds requires strict indications for admission. It turns out to be useful to create a category of patients in whom postoperative intensive care is desirable but not mandatory.
Utzolino
S
S
Universitätsklinikum der Albert-Ludwigs-Universität, Chirurgische Klinik, Allgemein- und Viszeralchirurgie, Hugstetterstrasse55, 79106 Freiburg, Deutschland. stefan.utzolino@uniklinikfreiburg.de
Lämmermann
L
L
Kaffarnik
M
M
Makowiec
F
F
Hopt
U-T
UT
D001509:Bed Occupancy / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D005858:Germany; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000628:therapy; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D019564:Unnecessary Procedures / Q000706:statistics & numerical data; D014600:Utilization Review / Q000706:statistics & numerical data