title: The impact of abdominal aortic aneurysm surgery on intensive care unit resources in an Irish tertiary centre.
abstract: BACKGROUND
  The potential impact of surgical service reconfiguration on intensive care unit (ICU) resources needs to be assessed.
  
  
  OBJECTIVE
  To determine the resources required to provide post-operative ICU care to patients undergoing open abdominal aortic aneurysm (AAA) repair or endovascular aneurysm repair (EVAR) at a specialist centre in the HSE South area
  
  
  METHODS
  For 198 patients, we calculated: (1) ICU bed-days; (2) organ support required; and (3) monetary cost of ICU care.
  
  
  RESULTS
  In total, 82.8% (101/122) of patients undergoing open AAA repair required post-operative ICU care (52 emergency and 49 elective). Emergency cases required more ICU bed-days (median 4.2 vs. 1.9, p<0.0005) and were more likely to require ventilation (odds ratio, OR 11.7, p<0.0001), inotropes (OR 3.1, p=0.01) or enteral nutrition (OR 23.3, p<0.0001). Mean cost per patient was €3,956 for elective cases and €16,419 for emergency cases. No patient required ICU admission after EVAR (n=76).
  
  
  CONCLUSIONS
  Open AAA surgery places significant demands on ICU resources. The planned reconfiguration of surgical services in Ireland must provide for parallel investment in ICU facilities and expertise.
authors.affiliation: Department of Anaesthesia and Intensive Care Medicine, Mercy University Hospital, Cork, Ireland. hannah_shiels@yahoo.co.uk
authors.forename: H
authors.initials: H
authors.lastname: Shiels
authors.forename: A N
authors.initials: AN
authors.lastname: Desmond
authors.forename: R
authors.initials: R
authors.lastname: Parimkayala
authors.forename: J
authors.initials: J
authors.lastname: Cahill
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000191:economics / Q000453:epidemiology / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000191:economics; D004630:Emergencies / Q000191:economics; D004750:Enteral Nutrition; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D007494:Ireland / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D011182:Postoperative Care; D012189:Retrospective Studies