Elective intensive care after lung resection: a multicentric propensity-matched comparison of outcome

a Unit of Thoracic Surgery ‘Umberto I’ Regional Hospital Ancona, Italy b Unit of Thoracic Surgery, ‘Bellaria’ Hospital Bologna, Italy c Anaesthesiology and Intensive Care Unit ‘Bellaria’ Hospital Bologna, Italy *Corresponding author: Dr A. Brunelli, Via S. Margherita 23, Ancona 60129, Italy. Tel.: +...

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Published in:Interactive cardiovascular and thoracic surgery 2005-12, Vol.4 (6), p.609-613
Main Authors: Brunelli, Alessandro, Pieretti, Paola, Al Refai, Majed, Lacava, Nicola, Xiume', Francesco, Boaron, Maurizio, Zanello, Marco, Sabbatini, Armando
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container_end_page 613
container_issue 6
container_start_page 609
container_title Interactive cardiovascular and thoracic surgery
container_volume 4
creator Brunelli, Alessandro
Pieretti, Paola
Al Refai, Majed
Lacava, Nicola
Xiume', Francesco
Boaron, Maurizio
Zanello, Marco
Sabbatini, Armando
description a Unit of Thoracic Surgery ‘Umberto I’ Regional Hospital Ancona, Italy b Unit of Thoracic Surgery, ‘Bellaria’ Hospital Bologna, Italy c Anaesthesiology and Intensive Care Unit ‘Bellaria’ Hospital Bologna, Italy *Corresponding author: Dr A. Brunelli, Via S. Margherita 23, Ancona 60129, Italy. Tel.: +39 0715964439; fax: +39 0715964433. E-mail address : alexit2000{at}yahoo.com (A. Brunelli). The study was aimed at assessing the influence of the elective ICU admission on the early outcome after major lung resection by analyzing the different postoperative management policies of two centers. Center A managed all patients in a dedicated ward, resorting to ICU for complications requiring invasive assisted ventilation. In center B, high-risk patients were electively transferred to ICU immediately after operation. Propensity score was used to match those patients of center B electively admitted to ICU (96 of 157), with counterparts from center A (96 of 205). The outcome of these matched pairs were then compared. There was a trend of reduced total morbidity (23% vs. 35%, respectively; P =0.06), cardiovascular (13.5% vs. 23%, respectively; P =0.09) and pulmonary complication rates (9.3% vs. 18%, respectively; P =0.09), but a longer postoperative hospital stay (11.5 vs. 9.7, respectively; P =0.015) in the patients electively admitted to ICU, compared to matched center A patients. Mortality rates were not different (7.3% vs. 7.3%; P =1). Since the elective postoperative ICU admission did not show a clear-cut outcome benefit over the management in a dedicated ward, this practice should be limited to highly selected patients in order to efficiently utilize the available resources. Key Words: Lung resection; Outcome; Intensive care management; Postoperative management; Morbidity; Mortality
doi_str_mv 10.1510/icvts.2005.116459
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title Elective intensive care after lung resection: a multicentric propensity-matched comparison of outcome
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