title: Is close monitoring in the intensive care unit necessary after elective liver resection?
abstract: OBJECTIVE
  Many surgical patients are admitted to the intensive care unit (ICU), resulting in an increased demand, and possible waste, of resources. Patients who undergo liver resection are also transferred postoperatively to the ICU. However, this may not be necessary in all cases. This study was designed to assess the necessity of ICU admission.
  
  
  METHODS
  The medical records of 313 patients who underwent liver resections, as performed by a single surgeon from March 2000 to December 2010 were retrospectively reviewed.
  
  
  RESULTS
  Among 313 patients, 168 patients (53.7%) were treated in the ICU. 148 patients (88.1%) received only observation during the ICU care. The ICU re-admission and intensive medical treatment significantly correlated with major liver resection (odds ratio [OR], 6.481; P = 0.011), and intraoperative transfusions (OR, 7.108; P = 0.016). Patients who underwent major liver resection and intraoperative transfusion were significantly associated with need for mechanical ventilator care, longer postoperative stays in the ICU and the hospital, and hospital mortality.
  
  
  CONCLUSIONS
  Most patients admitted to the ICU after major liver resection just received close monitoring. Even though patients underwent major liver resection, patients without receipt of intraoperative transfusion could be sent to the general ward. Duration of ICU/hospital stay, ventilator care and mortality significantly correlated with major liver resection and intraoperative transfusion. Major liver resection and receipt of intraoperative transfusions should be considered indicators for ICU admission.
authors.affiliation: Department of Surgery, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Jae Gil
authors.initials: JG
authors.lastname: Lee
authors.forename: So Young
authors.initials: SY
authors.lastname: Kwon
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Lim
authors.forename: Won Oak
authors.initials: WO
authors.lastname: Kim
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kim