Skinner, D.L.De Vasconcellos, K.Wise, R.Esterhuizen, T.M.Fourie, C.Mahomed, A. GoolamGopalan, P.D.Joubert, I.Kluyts, Hyla-LouiseMathivha, L.R.Mrara, BusisiwePretorius, Jan P.Richards, Guy A.Smith, O.Spruyt, M.G.L.Pearse, R.M.Madiba, T.E.Biccard, Bruce McIure2017-07-312017-07-312017-05Skinner 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. 411-419.0256-9574 (print)2078-5135 (online)10.7196/SAMJ.2017.v107i5.11455http://hdl.handle.net/2263/61528BACKGROUND. 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 ClinicalTrials.gov (NCT02141867).en© 2017 Health & Medical Publishing Group. This article is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0).Surgical careCritical carePatientsSouth Africa (SA)Article