Abstract
Objective: To establish the frequency of intensive care unit (ICU) admission after esophagectomy and to determine the associated outcomes. Design: Retrospective cohort study. Setting: Tertiary referral center. Participants: Four hundred thirty-two patients who underwent esophagectomy between January 2000 and June 2004. Interventions: None. Measurements and Main Results: Data relating to demographics, patient co-morbidities, perioperative management, complications, and Acute Physiology and Chronic Health Evaluation (APACHE) III variables were abstracted. Statistical analyses were performed to compare survivors with non-survivors and ICU patients with non-ICU patients. Of 432 patients included in the study, 123 (28.5%) were admitted to the ICU. Arrhythmias, new infiltrates on chest radiograph, and documented aspiration were common reasons for ICU admission. Patients admitted to ICU were of high acuity (mean APACHE III score 54.5, mean prediction of ICU death 6.4%). Of 352 patients originally not sent to the ICU, 43 (12.2%) were subsequently admitted to the ICU, often for aspiration. Overall in-hospital mortality was 3.7% (16 of 432 patients). Fifteen of the 123 ICU patients (12.2%) did not survive to hospital discharge. Conclusions: A significant minority of patients will require ICU admission after esophagectomy, often for aspiration pneumonitis and arrhythmias. Despite high severity of illness scores, the perioperative mortality rate for patients after esophagectomy at a high-volume center is low.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 440-446 |
| Number of pages | 7 |
| Journal | Journal of Cardiothoracic and Vascular Anesthesia |
| Volume | 24 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2010 |
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Keywords
- APACHE
- esophagectomy
- intensive care unit
- perioperative
- postoperative outcomes
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Anesthesiology and Pain Medicine
Cite this
Intensive Care Unit Utilization and Outcome After Esophagectomy. / Iscimen, Remzi; Brown, Daniel R.; Cassivi, Stephen D.; Keegan, Mark T.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 24, No. 3, 2010, p. 440-446.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intensive Care Unit Utilization and Outcome After Esophagectomy
AU - Iscimen, Remzi
AU - Brown, Daniel R.
AU - Cassivi, Stephen D.
AU - Keegan, Mark T.
PY - 2010
Y1 - 2010
N2 - Objective: To establish the frequency of intensive care unit (ICU) admission after esophagectomy and to determine the associated outcomes. Design: Retrospective cohort study. Setting: Tertiary referral center. Participants: Four hundred thirty-two patients who underwent esophagectomy between January 2000 and June 2004. Interventions: None. Measurements and Main Results: Data relating to demographics, patient co-morbidities, perioperative management, complications, and Acute Physiology and Chronic Health Evaluation (APACHE) III variables were abstracted. Statistical analyses were performed to compare survivors with non-survivors and ICU patients with non-ICU patients. Of 432 patients included in the study, 123 (28.5%) were admitted to the ICU. Arrhythmias, new infiltrates on chest radiograph, and documented aspiration were common reasons for ICU admission. Patients admitted to ICU were of high acuity (mean APACHE III score 54.5, mean prediction of ICU death 6.4%). Of 352 patients originally not sent to the ICU, 43 (12.2%) were subsequently admitted to the ICU, often for aspiration. Overall in-hospital mortality was 3.7% (16 of 432 patients). Fifteen of the 123 ICU patients (12.2%) did not survive to hospital discharge. Conclusions: A significant minority of patients will require ICU admission after esophagectomy, often for aspiration pneumonitis and arrhythmias. Despite high severity of illness scores, the perioperative mortality rate for patients after esophagectomy at a high-volume center is low.
AB - Objective: To establish the frequency of intensive care unit (ICU) admission after esophagectomy and to determine the associated outcomes. Design: Retrospective cohort study. Setting: Tertiary referral center. Participants: Four hundred thirty-two patients who underwent esophagectomy between January 2000 and June 2004. Interventions: None. Measurements and Main Results: Data relating to demographics, patient co-morbidities, perioperative management, complications, and Acute Physiology and Chronic Health Evaluation (APACHE) III variables were abstracted. Statistical analyses were performed to compare survivors with non-survivors and ICU patients with non-ICU patients. Of 432 patients included in the study, 123 (28.5%) were admitted to the ICU. Arrhythmias, new infiltrates on chest radiograph, and documented aspiration were common reasons for ICU admission. Patients admitted to ICU were of high acuity (mean APACHE III score 54.5, mean prediction of ICU death 6.4%). Of 352 patients originally not sent to the ICU, 43 (12.2%) were subsequently admitted to the ICU, often for aspiration. Overall in-hospital mortality was 3.7% (16 of 432 patients). Fifteen of the 123 ICU patients (12.2%) did not survive to hospital discharge. Conclusions: A significant minority of patients will require ICU admission after esophagectomy, often for aspiration pneumonitis and arrhythmias. Despite high severity of illness scores, the perioperative mortality rate for patients after esophagectomy at a high-volume center is low.
KW - APACHE
KW - esophagectomy
KW - intensive care unit
KW - perioperative
KW - postoperative outcomes
UR - http://www.scopus.com/inward/record.url?scp=77952584296&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77952584296&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2008.02.002
DO - 10.1053/j.jvca.2008.02.002
M3 - Article
C2 - 18834773
AN - SCOPUS:77952584296
VL - 24
SP - 440
EP - 446
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 3
ER -