Volume 6 Supplement 2

19th Spring Meeting of the Association of Cardiothoracic Anaesthetists

Open Access

An audit of re-admission to intensive care after initial recovery from pulmonary resection: is it worthwhile?

  • JE Pilling1,
  • AE Martin-Ucar1 and
  • DA Waller1
Critical Care20026(Suppl 2):3

https://doi.org/10.1186/cc1807

Published: 9 July 2002

Objective

To audit the outcome of patients admitted to a general intensive care unit (ICU) from a thoracic high dependency unit (HDU) after pulmonary resection.

Methods

A retrospective case note review of 28 consecutive patients (22 male, six female; median age, 66 years [range, 48–80 years]) admitted to the ICU following initial recovery on an HDU after pulmonary resection, in a 3-year period, in a single surgeon thoracic surgical practice.

Results

ICU and 6-month mortalities were 47% (13 patients) and 64% (18 patients), respectively. Need for mechanical ventilation (P = 0.006) and subsequent renal support (P = 0.05) were predictors of hospital mortality on multivariate analysis. All four patients who required both ventilation and renal support died. Only two of 17 patients (12%) who required mechanical ventilation were alive at 6 months (P = 0.002). Age, sex, preoperative pulmonary function, extent of resection, diagnosis, need for reoperation and inotropic requirements were not predictors of poor outcome. Patients who died in the ICU (n = 13) stayed for longer (mean, 17.6 days versus 5.3 days; P = 0.04) and at a higher average cost per patient (£21,992 versus £5300; P = 0.04) than those who survived (n = 15).

Conclusions

Mechanical ventilation for subsequent respiratory complications after initial recovery from lung resection is generally not worthwhile.
 

Hospital mortality

6-month mortality

Age

  

   < 70 years

47% (9 of 19)

63% (12 of 19)

   > 70 years

44% (4 of 9)

67% (6 of 9)

FEV1%

  

   < 70% predicted

27% (3 of 11)

64% (7 of 11)

   > 70% predicted

59% (10 of 17)

65% (11 of 17)

Histology

  

   Malignant

43% (10 of 23)

65% (15 of 23)

   Benign

60% (3 of 5)

60% (3 of 5)

Mechanical ventilation

  

   Yes

76% (13 of 17)

88% (15 of 17)

   No

0% (0 of 11)

27% (3 of 11)

Renal support required

  

   Yes

73% (11 of 15)

87% (13 of 15)

   No

15 % (2 of 13)

38% (5 of 13)

FEV1%, forced expiratory volume in 1 s as a percentage of forced vital capacity.

Authors’ Affiliations

(1)
Department of Thoracic Surgery, Glenfield Hospital

Copyright

© BioMed Central Ltd 2002

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