Critical care admission of South African (SA) surgical patients : results of the SA surgical outcomes study

Show simple item record Skinner, D.L. De Vasconcellos, K. Wise, R. Esterhuizen, T.M. Fourie, C. Mahomed, A. Goolam Gopalan, P.D. Joubert, I. Kluyts, Hyla-Louise Mathivha, L.R. Mrara, Busisiwe Pretorius, Jan P. Richards, Guy A. Smith, O. Spruyt, M.G.L. Pearse, R.M. Madiba, T.E. Biccard, Bruce McIure 2017-07-31T09:24:30Z 2017-07-31T09:24:30Z 2017-05
dc.description.abstract BACKGROUND. Appropriate critical care admissions are an important component of surgical care. However, there are few data describing postoperative critical care admission in resource-limited low- and middle-income countries. OBJECTIVE. To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical care units in South Africa (SA). METHODS. The SA Surgical Outcomes Study (SASOS) was a 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals. All patients admitted to critical care units during this study were included for analysis. RESULTS. Of the 3 927 SASOS patients, 255 (6.5%) were admitted to critical care units; of these admissions, 144 (56.5%) were planned, and 111 (43.5%) unplanned. The incidence of confirmed or strongly suspected infection at the time of admission was 35.4%, with a significantly higher incidence in unplanned admissions (49.1 v. 24.8%, p<0.001). Unplanned admission cases were more frequently hypovolaemic, had septic shock, and required significantly more inotropic, ventilatory and renal support in the first 48 hours after admission. Overall mortality was 22.4%, with unplanned admissions having a significantly longer critical care length of stay and overall mortality (33.3 v. 13.9%, p<0.001). CONCLUSION. The outcome of patients admitted to public sector critical care units in SA is strongly associated with unplanned admissions. Adequate ‘high care-dependency units’ for postoperative care of elective surgical patients could potentially decrease the burden on critical care resources in SA by 23%. This study was registered on (NCT02141867). en_ZA
dc.description.department Surgery en_ZA
dc.description.librarian am2017 en_ZA
dc.description.sponsorship SASA and the Vascular Association of SA (VASSA). en_ZA
dc.description.uri en_ZA
dc.identifier.citation Skinner D.L., De Vasconcellos K., Wise R., Esterhuizen T.M., Fourie C., Mahomed A.G., Gopalan P.D., Joubert I., Kluyts H.-L., Mathivha L.R., Mrara B., Pretorius J.P., Richards G., Smith O., Spruyt M.G.L., Pearse R.M., Madiba T.E., Biccard B.M. 2017, 'Critical care admission of South African (SA) surgical patients : results of the SA surgical outcomes study', South African Medical Journal, vol. 107, no. 5, pp. 411-419. en_ZA
dc.identifier.issn 0256-9574 (print)
dc.identifier.issn 2078-5135 (online)
dc.identifier.other 10.7196/SAMJ.2017.v107i5.11455
dc.language.iso en en_ZA
dc.publisher Health and Medical Publishing Group en_ZA
dc.rights © 2017 Health & Medical Publishing Group. This article is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0). en_ZA
dc.subject Surgical care en_ZA
dc.subject Critical care en_ZA
dc.subject Patients en_ZA
dc.subject South Africa (SA) en_ZA
dc.title Critical care admission of South African (SA) surgical patients : results of the SA surgical outcomes study en_ZA
dc.type Article en_ZA

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