| Title |
Intensive care utilization following major noncardiac surgical procedures in Ontario, Canada: a population-based study
|
|---|---|
| Published in |
Intensive Care Medicine, July 2018
|
| DOI | 10.1007/s00134-018-5330-6 |
| Pubmed ID | |
| Authors |
Angela Jerath, Andreas Laupacis, Peter C. Austin, Hannah Wunsch, Duminda N. Wijeysundera |
| Abstract |
Patients are sometimes admitted to intensive care units (ICU) after elective noncardiac surgery for advanced monitoring and treatments not available on a general postsurgical ward. However, patterns of ICU utilization are poorly understood. Our aims were to assess the incidence and determinants of ICU utilization after elective noncardiac surgical procedures. Population-based cohort study included adult patients who underwent 13 types of major elective noncardiac surgical procedures between 2006 and 2014 in Ontario, Canada. Primary outcome was early admission to ICU within 24 h after surgery. A prespecified analysis using multilevel logistic regression modeling separately examined patient- and hospital-level factors associated with early ICU admission within distinct groups of surgical procedures. Early ICU admission occurred in 9.6% of the included 541,524 patients. Patients admitted early to ICU showed higher median age (68 vs. 65 years), burden of prehospital comorbidities (Charlson comorbidity index score ≥ 2, 33.1 vs. 10.4%), 30-day mortality rates (2.4 vs. 0.3%), and longer median postoperative hospital stays (6 vs. 4 days) than patients admitted to a ward. There was wide variation in proportions of patients admitted early to ICU across different surgery types (0.9% for hysterectomy to 90.8% for open abdominal aortic aneurysm repair) with generally low 30-day mortality across procedures (0.1-2.8%). Within individual procedures, there was wide interhospital variation in the range of early ICU admission rates (hysterectomy 0.07-14.4%, lower gastrointestinal resection 1.3-95%, endovascular aortic aneurysm 1.3-95.2%). The individual hospital where surgery was performed accounted for a large proportion of the variation in early ICU admission rates, with the median odds ratio ranging from 2.3 for hysterectomy to 21.5 for endovascular aortic aneurysm. There is a wide variation in early ICU admission across and within surgical procedures. The individual hospital accounts for a large proportion of this variation. Further research is required to identify the basis for this variation and to develop better methods for allocating ICU resources for postoperative management of surgical patients. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| France | 1 | 11% |
| Malaysia | 1 | 11% |
| Unknown | 7 | 78% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 67% |
| Practitioners (doctors, other healthcare professionals) | 2 | 22% |
| Scientists | 1 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 55 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 55 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 13% |
| Student > Ph. D. Student | 6 | 11% |
| Student > Bachelor | 6 | 11% |
| Student > Doctoral Student | 5 | 9% |
| Researcher | 5 | 9% |
| Other | 12 | 22% |
| Unknown | 14 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 27 | 49% |
| Nursing and Health Professions | 3 | 5% |
| Psychology | 2 | 4% |
| Business, Management and Accounting | 1 | 2% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Other | 3 | 5% |
| Unknown | 18 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 October 2018.
All research outputs
#6,922,301
of 24,166,768 outputs
Outputs from Intensive Care Medicine
#2,818
of 5,212 outputs
Outputs of similar age
#115,030
of 334,108 outputs
Outputs of similar age from Intensive Care Medicine
#78
of 122 outputs
Altmetric has tracked 24,166,768 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 5,212 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 28.9. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 334,108 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.
We're also able to compare this research output to 122 others from the same source and published within six weeks on either side of this one. This one is in the 36th percentile – i.e., 36% of its contemporaries scored the same or lower than it.