Perioperative optimisation may be associated with different ICU outcomes in AAA and major thoracotomy

Introduction

The importance of perioperative optimisation using fluid or inotropic agents has been underestimated, although it is recognised that preoperative optimisation may improve postoperative mortality after major surgery. Both abdominal aortic aneurysm (AAA) and major thoracic surgery have among the highest postoperative mortality rates. In our institute, all AAA (elective or emergency) patients receive perioperative optimisation in the ICU while all major thoracotomy (oesophagectomy or pneumonectomy) patients are cared for by the surgical team on the HDU or ward until ICU treatments are required. The aim of this study was to compare ICU overall outcomes between AAA and major thoracotomy groups.

Methods

The data were collected from the ICNARC of 429 patients who underwent AAA (n = 211) and major thoracotomy (n = 218) between February 1996 and August 2001. The Mann–Whitney U test and chi-square test were used for statistical analysis.

Results

AAA group had significant lower APACHE II score, length of ICU stay and ICU mortality despite of greater age, ASA grades and number of emergency cases compared with the major thoracotomy group.

Conclusion

Perioperative optimisation may be associated with better ICU outcomes in the AAA group compared with the major thoracotomy group.

Table 1 Outcome of AAA and major thoratomy

Table 2 Outcome of survivals and nonsurvivals in AAA and thorocotomy