Elective intensive care after lung resection

A multicentric propensity-matched comparison of outcome

Alessandro Brunelli, Paola Pieretti, Majed Al Refai, Nicola Lacava, Francesco Xiume', Maurizio Boaron, Marco Zanello, Armando Sabbatini

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The study was aimed at assessing the influence of the elective ICU admission on the early outcome after major lung resection by analyzing the different postoperative management policies of two centers. Center A managed all patients in a dedicated ward, resorting to ICU for complications requiring invasive assisted ventilation. In center B, high-risk patients were electively transferred to ICU immediately after operation. Propensity score was used to match those patients of center B electively admitted to ICU (96 of 157), with counterparts from center A (96 of 205). The outcome of these matched pairs were then compared. There was a trend of reduced total morbidity (23% vs. 35%, respectively; P=0.06), cardiovascular (13.5% vs. 23%, respectively; P=0.09) and pulmonary complication rates (9.3% vs. 18%, respectively; P=0.09), but a longer postoperative hospital stay (11.5 vs. 9.7, respectively; P=0.015) in the patients electively admitted to ICU, compared to matched center A patients. Mortality rates were not different (7.3% vs. 7.3%; P=1). Since the elective postoperative ICU admission did not show a clear-cut outcome benefit over the management in a dedicated ward, this practice should be limited to highly selected patients in order to efficiently utilize the available resources.

Original languageEnglish
Pages (from-to)609-613
Number of pages5
JournalInteractive Cardiovascular and Thoracic Surgery
Volume4
Issue number6
DOIs
Publication statusPublished - Dec 1 2005

Fingerprint

Critical Care
Lung
Propensity Score
Ventilation
Length of Stay
Morbidity
Mortality

Keywords

  • Intensive care management
  • Lung resection
  • Morbidity
  • Mortality
  • Outcome
  • Postoperative management

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Elective intensive care after lung resection : A multicentric propensity-matched comparison of outcome. / Brunelli, Alessandro; Pieretti, Paola; Al Refai, Majed; Lacava, Nicola; Xiume', Francesco; Boaron, Maurizio; Zanello, Marco; Sabbatini, Armando.

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 4, No. 6, 01.12.2005, p. 609-613.

Research output: Contribution to journalArticle

Brunelli, Alessandro ; Pieretti, Paola ; Al Refai, Majed ; Lacava, Nicola ; Xiume', Francesco ; Boaron, Maurizio ; Zanello, Marco ; Sabbatini, Armando. / Elective intensive care after lung resection : A multicentric propensity-matched comparison of outcome. In: Interactive Cardiovascular and Thoracic Surgery. 2005 ; Vol. 4, No. 6. pp. 609-613.
@article{80c41137a20c483890848d01bb10706e,
title = "Elective intensive care after lung resection: A multicentric propensity-matched comparison of outcome",
abstract = "The study was aimed at assessing the influence of the elective ICU admission on the early outcome after major lung resection by analyzing the different postoperative management policies of two centers. Center A managed all patients in a dedicated ward, resorting to ICU for complications requiring invasive assisted ventilation. In center B, high-risk patients were electively transferred to ICU immediately after operation. Propensity score was used to match those patients of center B electively admitted to ICU (96 of 157), with counterparts from center A (96 of 205). The outcome of these matched pairs were then compared. There was a trend of reduced total morbidity (23{\%} vs. 35{\%}, respectively; P=0.06), cardiovascular (13.5{\%} vs. 23{\%}, respectively; P=0.09) and pulmonary complication rates (9.3{\%} vs. 18{\%}, respectively; P=0.09), but a longer postoperative hospital stay (11.5 vs. 9.7, respectively; P=0.015) in the patients electively admitted to ICU, compared to matched center A patients. Mortality rates were not different (7.3{\%} vs. 7.3{\%}; P=1). Since the elective postoperative ICU admission did not show a clear-cut outcome benefit over the management in a dedicated ward, this practice should be limited to highly selected patients in order to efficiently utilize the available resources.",
keywords = "Intensive care management, Lung resection, Morbidity, Mortality, Outcome, Postoperative management",
author = "Alessandro Brunelli and Paola Pieretti and {Al Refai}, Majed and Nicola Lacava and Francesco Xiume' and Maurizio Boaron and Marco Zanello and Armando Sabbatini",
year = "2005",
month = "12",
day = "1",
doi = "10.1510/icvts.2005.116459",
language = "English",
volume = "4",
pages = "609--613",
journal = "Interactive Cardiovascular and Thoracic Surgery",
issn = "1569-9293",
publisher = "European Association for Cardio-Thoracic Surgery",
number = "6",

}

TY - JOUR

T1 - Elective intensive care after lung resection

T2 - A multicentric propensity-matched comparison of outcome

AU - Brunelli, Alessandro

AU - Pieretti, Paola

AU - Al Refai, Majed

AU - Lacava, Nicola

AU - Xiume', Francesco

AU - Boaron, Maurizio

AU - Zanello, Marco

AU - Sabbatini, Armando

PY - 2005/12/1

Y1 - 2005/12/1

N2 - The study was aimed at assessing the influence of the elective ICU admission on the early outcome after major lung resection by analyzing the different postoperative management policies of two centers. Center A managed all patients in a dedicated ward, resorting to ICU for complications requiring invasive assisted ventilation. In center B, high-risk patients were electively transferred to ICU immediately after operation. Propensity score was used to match those patients of center B electively admitted to ICU (96 of 157), with counterparts from center A (96 of 205). The outcome of these matched pairs were then compared. There was a trend of reduced total morbidity (23% vs. 35%, respectively; P=0.06), cardiovascular (13.5% vs. 23%, respectively; P=0.09) and pulmonary complication rates (9.3% vs. 18%, respectively; P=0.09), but a longer postoperative hospital stay (11.5 vs. 9.7, respectively; P=0.015) in the patients electively admitted to ICU, compared to matched center A patients. Mortality rates were not different (7.3% vs. 7.3%; P=1). Since the elective postoperative ICU admission did not show a clear-cut outcome benefit over the management in a dedicated ward, this practice should be limited to highly selected patients in order to efficiently utilize the available resources.

AB - The study was aimed at assessing the influence of the elective ICU admission on the early outcome after major lung resection by analyzing the different postoperative management policies of two centers. Center A managed all patients in a dedicated ward, resorting to ICU for complications requiring invasive assisted ventilation. In center B, high-risk patients were electively transferred to ICU immediately after operation. Propensity score was used to match those patients of center B electively admitted to ICU (96 of 157), with counterparts from center A (96 of 205). The outcome of these matched pairs were then compared. There was a trend of reduced total morbidity (23% vs. 35%, respectively; P=0.06), cardiovascular (13.5% vs. 23%, respectively; P=0.09) and pulmonary complication rates (9.3% vs. 18%, respectively; P=0.09), but a longer postoperative hospital stay (11.5 vs. 9.7, respectively; P=0.015) in the patients electively admitted to ICU, compared to matched center A patients. Mortality rates were not different (7.3% vs. 7.3%; P=1). Since the elective postoperative ICU admission did not show a clear-cut outcome benefit over the management in a dedicated ward, this practice should be limited to highly selected patients in order to efficiently utilize the available resources.

KW - Intensive care management

KW - Lung resection

KW - Morbidity

KW - Mortality

KW - Outcome

KW - Postoperative management

UR - http://www.scopus.com/inward/record.url?scp=28544447051&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=28544447051&partnerID=8YFLogxK

U2 - 10.1510/icvts.2005.116459

DO - 10.1510/icvts.2005.116459

M3 - Article

VL - 4

SP - 609

EP - 613

JO - Interactive Cardiovascular and Thoracic Surgery

JF - Interactive Cardiovascular and Thoracic Surgery

SN - 1569-9293

IS - 6

ER -