title: The effects of intensive care unit staffing on patient outcomes following microvascular free flap reconstruction of the head and neck: a pilot study.
abstract: OBJECTIVE
  To determine if the implementation of the closed intensive care unit (ICU) at our institution altered clinical outcomes in patients who had undergone microvascular free flap reconstruction of the head and neck by the Otolaryngology-Head and Neck Surgery Service.
  
  
  METHODS
  Retrospective medical chart review.
  
  
  METHODS
  A single tertiary medical center.
  
  
  METHODS
  The open ICU cohort had 52 flaps performed on 50 patients, and the closed ICU cohort had 52 flaps performed on 52 patients.
  
  
  METHODS
  Fifty-two free flap reconstructions of head and neck defects were performed on 50 patients who were admitted to an open ICU. The length of stay (LOS) in the ICU and hospital and incidence of complications were compared with those of 52 patients who underwent 52 free flap reconstructions and were admitted to a closed ICU over a separate period.
  
  
  RESULTS
  The mean length of stay in the ICU was 44 and 45 hours in the open and closed ICU cohorts, respectively (P = .90). The incidence of surgical and medical complications was similar in the open and closed ICU cohorts (P > .05).
  
  
  CONCLUSIONS
  There does not appear to be a significant difference in patient outcome between open and closed ICU care in our study.
authors: Division of Facial Plastic Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02108, USA. pbhama@gmail.com
authors: Prabhat K
authors: PK
authors: Bhama
authors: Greg E
authors: GE
authors: Davis
authors: Amit D
authors: AD
authors: Bhrany
authors: Derek J
authors: DJ
authors: Lam
authors: Neal D
authors: ND
authors: Futran
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006257:Head / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014861:Washington / Q000453:epidemiology; D000078329:Workforce