Risk Stratification for the Intensive Care Unit Following Pancreaticoduodenectomy

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Steffen Deichmann - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Uwe Ballies - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Ekaterina Petrova - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Louisa Bolm - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Kim Honselmann - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Laura Frohneberg - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Tobias Keck - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Ulrich Friedrich Wellner - , Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Dirk Bausch - , Marien Hospital Herne - Universitätsklinikum der Ruhr-Universität Bochum (Autor:in)

Abstract

INTRODUCTION: In view of the limited capacities in intensive care units and the increasing economic burden, identification of risk factors could allow better and more efficient planning. Therefore, the aim of this study was to assess independent risk factors for the duration of intensive care unit stay after pancreatoduodenectomy (PD).

METHODS: 147 patients who underwent pancreatoduodenectomy in the time period from 2013 to 2015 were identified from a prospective database and a retrospective analysis was performed. The primary endpoint was length of time spent in the ICU. A retrograde analysis was performed using univariate and multivariate regression analysis. All pre-, intra- and postoperative parameters were considered in the analysis.

RESULTS: The median time spent in the intensive care unit (ICU) is one day. The univariate analysis demonstrated increased pack years, cerebrovascular events, anticoagulation, elevated creatinine and CA 19-9 as preoperative risk factors. In multivariate analysis, antihypertensive medication (AHT; OR 2.46; 95% CI 1.57 - 3.87; p = 0.05), operation time (OR 1.01; 95% CI 1.00 - 1.01; p = 0.03), extended LAD (OR 5.46; 95% CI 2.77 - 10.75; p = 0.01) and severe PPH (OR 4.01; 95% CI 2.07 - 7.76; p = 0.04) are significant risk factors for longer ICU stay.

DISCUSSION: Patients with cardiovascular risk factors and elevated preoperative creatinine level are at greater risk for a prolonged ICU stay. Risk and benefit of an extended LAD should be weighed during the operation. Median duration on ICU/IMC after PD is one day or less for patients without risk factors. Whether routine monitoring in the ICU/IMC after PD is necessary must be clarified in further studies.

Details

OriginalspracheEnglisch
Seiten (von - bis)492-502
Seitenumfang11
FachzeitschriftZentralblatt fur Chirurgie
Jahrgang147
Ausgabenummer5
PublikationsstatusVeröffentlicht - Okt. 2022
Peer-Review-StatusJa
Extern publiziertJa

Externe IDs

Scopus 85139739226

Schlagworte

Schlagwörter

  • Anticoagulants, Antihypertensive Agents, Creatinine, Humans, Intensive Care Units, Length of Stay, Pancreaticoduodenectomy/adverse effects, Retrospective Studies, Risk Assessment, Risk Factors

Bibliotheksschlagworte