Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery : Secondary Analysis Of POWER Trial
© 2023. The Society for Surgery of the Alimentary Tract..
BACKGROUND: The efficacy of routine admission of high-risk patients to a critical care unit after surgery is not clear. The aim of our study was to investigate the association between critical care admission after scheduled colorectal surgery and postoperative complications, 30-day mortality, and length of stay in hospital.
METHODS: A pre-defined secondary substudy of POWER study was performed. POWER study was a prospective multicenter observational study of patients undergoing elective primary colorectal surgery during a single period of two months of recruitment between September and December 2017.
RESULTS: A total of 2084 patients from 80 Spanish hospitals were included, of which 722 (34.6%) were admitted to critical care unit (CCU) after elective surgery. After adjusting for confounding factors in the multivariate analysis, postoperative CCU admission was independently associated with a higher incidence of moderate-to-severe postoperative complications (adjusted OR 1.951, 95% CI 1.570, 2.425; p < 0.001). Regarding secondary outcomes, postoperative critical care admission was independently associated with higher 30-day mortality (adjusted OR 6.736; 95% CI 2.507, 18.101; p < 0.001) and independently associated with an increased hospital length of stay (adjusted OR 1.143, 95% CI 1.112, 1.175; p < 0.001).
CONCLUSIONS: Direct admission to CCU after scheduled colorectal surgery was not associated with a reduction in moderate-to-severe postoperative complications.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract - 27(2023), 10 vom: 20. Okt., Seite 2187-2198 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Colorectal surgery |
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| Anmerkungen: |
Date Completed 14.02.2024 Date Revised 21.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s11605-023-05780-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360502520 |
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| 041 | |a eng | ||
| 100 | 1 | |a Suárez-de-la-Rica, Alejandro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery |b Secondary Analysis Of POWER Trial |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 14.02.2024 | ||
| 500 | |a Date Revised 21.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Society for Surgery of the Alimentary Tract. | ||
| 520 | |a BACKGROUND: The efficacy of routine admission of high-risk patients to a critical care unit after surgery is not clear. The aim of our study was to investigate the association between critical care admission after scheduled colorectal surgery and postoperative complications, 30-day mortality, and length of stay in hospital | ||
| 520 | |a METHODS: A pre-defined secondary substudy of POWER study was performed. POWER study was a prospective multicenter observational study of patients undergoing elective primary colorectal surgery during a single period of two months of recruitment between September and December 2017 | ||
| 520 | |a RESULTS: A total of 2084 patients from 80 Spanish hospitals were included, of which 722 (34.6%) were admitted to critical care unit (CCU) after elective surgery. After adjusting for confounding factors in the multivariate analysis, postoperative CCU admission was independently associated with a higher incidence of moderate-to-severe postoperative complications (adjusted OR 1.951, 95% CI 1.570, 2.425; p < 0.001). Regarding secondary outcomes, postoperative critical care admission was independently associated with higher 30-day mortality (adjusted OR 6.736; 95% CI 2.507, 18.101; p < 0.001) and independently associated with an increased hospital length of stay (adjusted OR 1.143, 95% CI 1.112, 1.175; p < 0.001) | ||
| 520 | |a CONCLUSIONS: Direct admission to CCU after scheduled colorectal surgery was not associated with a reduction in moderate-to-severe postoperative complications | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Colorectal surgery | |
| 650 | 4 | |a Intensive care | |
| 650 | 4 | |a Perioperative medicine | |
| 650 | 4 | |a Postoperative complications | |
| 700 | 1 | |a Ripollés-Melchor, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Aldecoa, César |e verfasserin |4 aut | |
| 700 | 1 | |a Abad-Motos, Ane |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrando, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Abad-Gurumeta, Alfredo |e verfasserin |4 aut | |
| 700 | 1 | |a Díaz-Almirón, Mariana |e verfasserin |4 aut | |
| 700 | 1 | |a Gil-Lapetra, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a García-Miguel, Francisco Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Pedregosa-Sanz, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Esteve-Pérez, Neus |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez-Jiménez, Rita |e verfasserin |4 aut | |
| 700 | 1 | |a Gimeno Fernandez, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Maseda, Emilio |e verfasserin |4 aut | |
| 700 | 0 | |a POWER Study Investigators Group for the Spanish Perioperative Audit and Research Network (RedGERM-SPARN) |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Perez, Cristina |e investigator |4 oth | |
| 700 | 1 | |a Higuera-Míguelez, Eva |e investigator |4 oth | |
| 700 | 1 | |a Marcos-Vidal, José M |e investigator |4 oth | |
| 700 | 1 | |a Merino-García, María |e investigator |4 oth | |
| 700 | 1 | |a Rubio-López, Ana B |e investigator |4 oth | |
| 700 | 1 | |a Pascual-Diez, María E |e investigator |4 oth | |
| 700 | 1 | |a García-Miguel, Francisco J |e investigator |4 oth | |
| 700 | 1 | |a Cabezudo-Sanjose, Luis R |e investigator |4 oth | |
| 700 | 1 | |a Martínez-Díaz, Ruth |e investigator |4 oth | |
| 700 | 1 | |a Alegría-Rebollo, Sara |e investigator |4 oth | |
| 700 | 1 | |a González-Rodríguez, José L |e investigator |4 oth | |
| 700 | 1 | |a Vega-Cruz, María S |e investigator |4 oth | |
| 700 | 1 | |a Martínez-Ragüés, Gema |e investigator |4 oth | |
| 700 | 1 | |a Gómez-Ríos, Manuel A |e investigator |4 oth | |
| 700 | 1 | |a Mosquera-Rodríguez, Eva |e investigator |4 oth | |
| 700 | 1 | |a Del-Río-Regueira, Sara |e investigator |4 oth | |
| 700 | 1 | |a Perez-Valdivieso, José R |e investigator |4 oth | |
| 700 | 1 | |a Martin-Vizcaino, Marta |e investigator |4 oth | |
| 700 | 1 | |a Hernandez-Garcia, Susana |e investigator |4 oth | |
| 700 | 1 | |a Yoldi-Murillo, Francisco J |e investigator |4 oth | |
| 700 | 1 | |a Salvador-Bravo, Miguel |e investigator |4 oth | |
| 700 | 1 | |a Rubial-Alvarez, Manuela |e investigator |4 oth | |
| 700 | 1 | |a Oteiza-Martinez, Fabiola |e investigator |4 oth | |
| 700 | 1 | |a Balen-Rivera, Enrique |e investigator |4 oth | |
| 700 | 1 | |a Garcia-Erce, José A |e investigator |4 oth | |
| 700 | 1 | |a Zugasti-Murillo, Ana |e investigator |4 oth | |
| 700 | 1 | |a Petrina-Jáuregui, María E |e investigator |4 oth | |
| 700 | 1 | |a Bustos-García, Domingo |e investigator |4 oth | |
| 700 | 1 | |a Sánchez-Conde, María P |e investigator |4 oth | |
| 700 | 1 | |a Rodríguez-Calvo, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Hernández-Valero, María A |e investigator |4 oth | |
| 700 | 1 | |a Angoso-Clavijo, María |e investigator |4 oth | |
| 700 | 1 | |a González-Fernández, Luis M |e investigator |4 oth | |
| 700 | 1 | |a Bravo-Riaño, Miguel A |e investigator |4 oth | |
| 700 | 1 | |a Arnes-Muñoz, María V |e investigator |4 oth | |
| 700 | 1 | |a Bustos-Molina, Filadelfo |e investigator |4 oth | |
| 700 | 1 | |a Paz-Martín, Daniel |e investigator |4 oth | |
| 700 | 1 | |a Vázquez-Vicente, Bárbara |e investigator |4 oth | |
| 700 | 1 | |a González-López, Lourdes |e investigator |4 oth | |
| 700 | 1 | |a Mínguez-Marín, Conrado |e investigator |4 oth | |
| 700 | 1 | |a Diz-Jueguen, Susana |e investigator |4 oth | |
| 700 | 1 | |a Seoane-Antelo, Jaime |e investigator |4 oth | |
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| 700 | 1 | |a Carrera-Dacosta, Ester |e investigator |4 oth | |
| 700 | 1 | |a Barreiro-Domínguez, Erica |e investigator |4 oth | |
| 700 | 1 | |a Piñeiro-Teijeiro, Alexandra |e investigator |4 oth | |
| 700 | 1 | |a Sanchez-Santos, Raquel |e investigator |4 oth | |
| 700 | 1 | |a Varela-Duran, Marina |e investigator |4 oth | |
| 700 | 1 | |a Diaz-Parada, Pilar |e investigator |4 oth | |
| 700 | 1 | |a Calero-Lillo, Aránzazu |e investigator |4 oth | |
| 700 | 1 | |a López-Lara, Manuel Ángel |e investigator |4 oth | |
| 700 | 1 | |a Muñoz-Collado, Salvador |e investigator |4 oth | |
| 700 | 1 | |a Valverde-Sintas, Juan |e investigator |4 oth | |
| 700 | 1 | |a Aznar-Puig, Silvia |e investigator |4 oth | |
| 700 | 1 | |a Troyano-Escribano, Daniel |e investigator |4 oth | |
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| 700 | 1 | |a Ibarzabal, Ainitze |e investigator |4 oth | |
| 700 | 1 | |a Lacy, Antonio M |e investigator |4 oth | |
| 700 | 1 | |a Sánchez-Martín, Rubén |e investigator |4 oth | |
| 700 | 1 | |a Martins-Cruz, Karina |e investigator |4 oth | |
| 700 | 1 | |a Pérez-Jiménez, Paula |e investigator |4 oth | |
| 700 | 1 | |a Casans-Francés, Rubén |e investigator |4 oth | |
| 700 | 1 | |a Longás, Javier |e investigator |4 oth | |
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| 700 | 1 | |a Elia, Manuela |e investigator |4 oth | |
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| 700 | 1 | |a Romero-Vargas, Esther |e investigator |4 oth | |
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