title: Epidemiology and outcomes of non-cardiac surgical patients in Brazilian intensive care units.
abstract: OBJECTIVE
  Due to the dramatic medical breakthroughs and an increasingly ageing population, the proportion of patients who are at risk of dying following surgery is increasing over time. The aim of this study was to evaluate the outcomes and the epidemiology of non-cardiac surgical patients admitted to the intensive care unit.
  
  
  METHODS
  A multicenter, prospective, observational, cohort study was carried out in 21 intensive care units. A total of 885 adult surgical patients admitted to a participating intensive care unit from April to June 2006 were evaluated and 587 patients were enrolled. Exclusion criteria were trauma, cardiac, neurological, gynecologic, obstetric and palliative surgeries. The main outcome measures were postoperative complications and intensive care unit and 90-day mortality rates.
  
  
  RESULTS
  Major and urgent surgeries were performed in 66.4% and 31.7% of the patients, respectively. The intensive care unit mortality rate was 15%, and 38% of the patients had postoperative complications. The most common complication was infection or sepsis (24.7%). Myocardial ischemia was diagnosed in only 1.9% of the patients. A total of 94 % of the patients who died after surgery had co-morbidities at the time of surgery (3.4 ± 2.2). Multiple organ failure was the main cause of death (53%).
  
  
  CONCLUSIONS
  Sepsis is the predominant cause of morbidity in patients undergoing non-cardiac surgery. In this patient population, multiple organ failure prevailed as the most frequent cause of death in the hospital.
authors.affiliation: Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil.
authors.forename: Suzana Margareth
authors.initials: SM
authors.lastname: Lobo
authors.affiliation: Serviço de Terapia Intensiva, Servidor Público Estadual.
authors.forename: Ederlon
authors.initials: E
authors.lastname: Rezende
authors.affiliation: Unidade Coronariana Intensiva, Hospital São Lucas, Rio de Janeiro, RJ, Brasil.
authors.forename: Marcos Freitas
authors.initials: MF
authors.lastname: Knibel
authors.affiliation: Centro de Terapia Intensiva, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Nilton Brandão da
authors.initials: NB
authors.lastname: Silva
authors.affiliation: Centro de Terapia Intensiva, Clínica Sorocaba, Rio de Janeiro, RJ, Brasil.
authors.forename: José Antonio Matos
authors.initials: JA
authors.lastname: Páramo
authors.affiliation: Centro de Terapia Intensiva, Clínica São Vicente, Rio de Janeiro, RJ, Brasil.
authors.forename: Flávio
authors.initials: F
authors.lastname: Nácul
authors.affiliation: Unidade de Terapia Intensiva de Adultos, Hospital Universitário, Universidade Federal da Paraíba, João Pessoa, PA, Brasil.
authors.forename: Ciro Leite
authors.initials: CL
authors.lastname: Mendes
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: Murilo
authors.initials: M
authors.lastname: Assunção
authors.affiliation: Centro de Terapia Intensiva, Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brasil.
authors.forename: Rubens Carmo
authors.initials: RC
authors.lastname: Costa Filho
authors.affiliation: Centro de Terapia Intensiva Adulto, Hospital Universitário, Universidade Federal do Mato Grosso do Sul, Campo Grande, RS, Brasil.
authors.forename: Cíntia C
authors.initials: CC
authors.lastname: Grion
authors.affiliation: Universidade Estadual de Londrina, Londrina, PR, Brasil.
authors.forename: Sérgio Felix
authors.initials: SF
authors.lastname: Pinto
authors.affiliation: Hospital de Terapia Intensiva.
authors.forename: Patricia M Veiga de Carvalho
authors.initials: PM
authors.lastname: Mello
authors.affiliation: Centro de Terapia Intensiva, Hospital Santa Luzia, Brasília, Brasil.
authors.forename: Marcelo de Oliveira
authors.initials: Mde O
authors.lastname: Maia
authors.affiliation: Universidade Estadual do Oeste do Paraná, Cascavel, PR, Brasil.
authors.forename: Péricles Almeida Delfino
authors.initials: PA
authors.lastname: Duarte
authors.affiliation: Centro de Terapia Intensiva, Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brasil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gutierrez
authors.affiliation: Hospital de Base, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brasil.
authors.forename: Renata
authors.initials: R
authors.lastname: Okabe
authors.affiliation: Hospital do Servidor Público Estadual.
authors.forename: João Manuel da
authors.initials: JM
authors.lastname: Silva Junior
authors.affiliation: Hospital Cardiotrauma Ipanema.
authors.forename: Aline Affonso de
authors.initials: AA
authors.lastname: Carvalho
authors.affiliation: Centro de Terapia Intensiva, Santa Casa de Misericórdia, Passos, MG, Brasil.
authors.forename: Marcel Rezende
authors.initials: MR
authors.lastname: Lopes