title: Predictors of intensive care unit utilization in gynecologic oncology surgery.
abstract: OBJECTIVE
  The objectives of the study were to examine factors predicting intensive care unit (ICU) admission after surgery for gynecologic cancer and to determine the impact of ICU admission on survival.
  
  
  METHODS
  This was a retrospective study of women undergoing laparotomy for staging and debulking of gynecologic cancer at an academic hospital with tertiary ICU facilities from July 2000 through June 2003. Data on clinicopathologic factors, comorbidities, operative outcomes, and survival were obtained from medical records and institutional cancer registry. The χ analysis, Kaplan-Meier analysis, and Cox regression methods were used for analyses.
  
  
  RESULTS
  Two hundred fifty-five patients met our inclusion criteria, 43 of whom had a postoperative admission to the ICU. Factors predicting ICU admission on univariate analysis included age 60 years or older, hematocrit of 30% or less, albumin of 3.5 g/dL or less, and Charlson Comorbidity Index (CCI) score greater than 8; after multivariate analysis, CCI score of greater than 8 (hazard ratio, 2.5; confidence interval, 1.11-5.69) and albumin of 3.5 or less (hazard ratio, 3.8; confidence interval, 1.66-8.85) were associated with an increased risk of ICU admission. After adjusting for albumin and CCI score, ICU admission did not have a significant effect on survival.
  
  
  CONCLUSIONS
  The ability to predict ICU admission helps in appropriate counseling of patients and identification of institutional resource utilization.
authors: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Reproductive Sciences, Helen Diller Family Cancer Center, University of California, CA, USA.
authors: Rachel
authors: R
authors: Ruskin
authors: Renata R
authors: RR
authors: Urban
authors: Alexander E
authors: AE
authors: Sherman
authors: Lee-Lynn
authors: LL
authors: Chen
authors: C Bethan
authors: CB
authors: Powell
authors: Daniel H
authors: DH
authors: Burkhardt
authors: Lee-May
authors: LM
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008875:Middle Aged; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012495:San Francisco / Q000453:epidemiology; D055815:Young Adult