Overnight intensive recovery: elective open aortic surgery without a routine ICU bed

C J Callaghan; A G Lynch; I Amin; M Fazel; M J Lindop; M E Gaunt; K Varty

doi:10.1016/j.ejvs.2005.03.004

Overnight intensive recovery: elective open aortic surgery without a routine ICU bed

C J Callaghan, A G Lynch, I Amin, M Fazel, M J Lindop, M E Gaunt, K Varty

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: Most patients are managed on the intensive care unit (ICU) after elective open aortic surgery. We preoperatively identify patients suitable for extubation in theatre with overnight management in theatre recovery before discharge back to the ward (overnight intensive recovery (OIR)). The safety of this was investigated.

DESIGN: Retrospective case note analysis of all patients who underwent EOAS from 1998 to 2002, recording in-hospital morbidity and mortality. Physiological and operative severity score for the enUmeration of mortality and morbidity (POSSUM) data were collected prospectively.

METHODS: Patients were divided into those selected for OIR and those booked for elective ICU admission. Observed morbidity and mortality data were compared with predicted outcomes generated by Portsmouth-POSSUM and POSSUM equations.

RESULTS: Hundred and fifty-two out of 178 patients used OIR; 155 patients had abdominal aortic aneurysm (AAA) repair. The elective ICU group had significantly higher anaesthetic risk scores (ASA grade), larger AAA, greater intraoperative blood loss and longer operations. In the OIR group, ten patients (7%) needed ICU admission within 48h postoperatively. Complications occurred in 85/152, with two deaths. There was no excess morbidity or mortality in the OIR group (predicted 95% CI 83-105 and 5-17, respectively).

CONCLUSION: Most patients having elective open aortic surgery can be managed safely using OIR.

Original language	English
Pages (from-to)	252-8
Number of pages	7
Journal	European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
Volume	30
Issue number	3
DOIs	https://doi.org/10.1016/j.ejvs.2005.03.004
Publication status	Published - Sept 2005

Keywords

Aged
Anesthesia Recovery Period
Aorta
Aortic Aneurysm, Abdominal
Blood Vessel Prosthesis Implantation
Critical Care
Female
Health Status Indicators
Hospital Mortality
Humans
Intensive Care Units
Male
Recovery Room
Retrospective Studies
Survival Analysis
Journal Article

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10.1016/j.ejvs.2005.03.004

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title = "Overnight intensive recovery: elective open aortic surgery without a routine ICU bed",

abstract = "OBJECTIVES: Most patients are managed on the intensive care unit (ICU) after elective open aortic surgery. We preoperatively identify patients suitable for extubation in theatre with overnight management in theatre recovery before discharge back to the ward (overnight intensive recovery (OIR)). The safety of this was investigated.DESIGN: Retrospective case note analysis of all patients who underwent EOAS from 1998 to 2002, recording in-hospital morbidity and mortality. Physiological and operative severity score for the enUmeration of mortality and morbidity (POSSUM) data were collected prospectively.METHODS: Patients were divided into those selected for OIR and those booked for elective ICU admission. Observed morbidity and mortality data were compared with predicted outcomes generated by Portsmouth-POSSUM and POSSUM equations.RESULTS: Hundred and fifty-two out of 178 patients used OIR; 155 patients had abdominal aortic aneurysm (AAA) repair. The elective ICU group had significantly higher anaesthetic risk scores (ASA grade), larger AAA, greater intraoperative blood loss and longer operations. In the OIR group, ten patients (7%) needed ICU admission within 48h postoperatively. Complications occurred in 85/152, with two deaths. There was no excess morbidity or mortality in the OIR group (predicted 95% CI 83-105 and 5-17, respectively).CONCLUSION: Most patients having elective open aortic surgery can be managed safely using OIR.",

keywords = "Aged, Anesthesia Recovery Period, Aorta, Aortic Aneurysm, Abdominal, Blood Vessel Prosthesis Implantation, Critical Care, Female, Health Status Indicators, Hospital Mortality, Humans, Intensive Care Units, Male, Recovery Room, Retrospective Studies, Survival Analysis, Journal Article",

author = "Callaghan, {C J} and Lynch, {A G} and I Amin and M Fazel and Lindop, {M J} and Gaunt, {M E} and K Varty",

year = "2005",

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doi = "10.1016/j.ejvs.2005.03.004",

language = "English",

volume = "30",

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publisher = "W.B. Saunders Ltd",

number = "3",

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T1 - Overnight intensive recovery

T2 - elective open aortic surgery without a routine ICU bed

AU - Callaghan, C J

AU - Lynch, A G

AU - Amin, I

AU - Fazel, M

AU - Lindop, M J

AU - Gaunt, M E

AU - Varty, K

PY - 2005/9

Y1 - 2005/9

N2 - OBJECTIVES: Most patients are managed on the intensive care unit (ICU) after elective open aortic surgery. We preoperatively identify patients suitable for extubation in theatre with overnight management in theatre recovery before discharge back to the ward (overnight intensive recovery (OIR)). The safety of this was investigated.DESIGN: Retrospective case note analysis of all patients who underwent EOAS from 1998 to 2002, recording in-hospital morbidity and mortality. Physiological and operative severity score for the enUmeration of mortality and morbidity (POSSUM) data were collected prospectively.METHODS: Patients were divided into those selected for OIR and those booked for elective ICU admission. Observed morbidity and mortality data were compared with predicted outcomes generated by Portsmouth-POSSUM and POSSUM equations.RESULTS: Hundred and fifty-two out of 178 patients used OIR; 155 patients had abdominal aortic aneurysm (AAA) repair. The elective ICU group had significantly higher anaesthetic risk scores (ASA grade), larger AAA, greater intraoperative blood loss and longer operations. In the OIR group, ten patients (7%) needed ICU admission within 48h postoperatively. Complications occurred in 85/152, with two deaths. There was no excess morbidity or mortality in the OIR group (predicted 95% CI 83-105 and 5-17, respectively).CONCLUSION: Most patients having elective open aortic surgery can be managed safely using OIR.

AB - OBJECTIVES: Most patients are managed on the intensive care unit (ICU) after elective open aortic surgery. We preoperatively identify patients suitable for extubation in theatre with overnight management in theatre recovery before discharge back to the ward (overnight intensive recovery (OIR)). The safety of this was investigated.DESIGN: Retrospective case note analysis of all patients who underwent EOAS from 1998 to 2002, recording in-hospital morbidity and mortality. Physiological and operative severity score for the enUmeration of mortality and morbidity (POSSUM) data were collected prospectively.METHODS: Patients were divided into those selected for OIR and those booked for elective ICU admission. Observed morbidity and mortality data were compared with predicted outcomes generated by Portsmouth-POSSUM and POSSUM equations.RESULTS: Hundred and fifty-two out of 178 patients used OIR; 155 patients had abdominal aortic aneurysm (AAA) repair. The elective ICU group had significantly higher anaesthetic risk scores (ASA grade), larger AAA, greater intraoperative blood loss and longer operations. In the OIR group, ten patients (7%) needed ICU admission within 48h postoperatively. Complications occurred in 85/152, with two deaths. There was no excess morbidity or mortality in the OIR group (predicted 95% CI 83-105 and 5-17, respectively).CONCLUSION: Most patients having elective open aortic surgery can be managed safely using OIR.

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KW - Aortic Aneurysm, Abdominal

KW - Blood Vessel Prosthesis Implantation

KW - Critical Care

KW - Female

KW - Health Status Indicators

KW - Hospital Mortality

KW - Humans

KW - Intensive Care Units

KW - Male

KW - Recovery Room

KW - Retrospective Studies

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JO - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

JF - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

IS - 3

ER -

Overnight intensive recovery: elective open aortic surgery without a routine ICU bed

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