An analysis of unplanned postoperative admissions to the intensive care units at different hospitals across Hamad Medical Corporation in Qatar

TL;DR

This study examines unplanned intensive care admissions after surgery in Qatar, finding that most are surgery-related and that the rate is within global averages.

Contribution

The study provides a multicenter analysis of unplanned ICU admissions in Qatar, highlighting lower anesthesia-related rates compared to prior research.

Findings

The overall rate of unplanned ICU admissions was 2%, consistent with global reports.

Most unplanned admissions were surgery-related (54.8%), followed by anesthesia-related (26.2%).

Anesthesia-related unplanned admissions were lower in this study compared to previous studies.

Abstract

An unplanned intensive care admission (UIA) after elective surgery is a clinical indicator of patient safety and outcomes. Furthermore, it reflects both surgery- and anesthesia-related complications. The overall rate of UIA ranges from 0.28% to 2.2%. UIA is linked with higher rates ofmorbidity and mortality in surgical patients. Thus, understanding the factors leading to UIAs could improve the quality of patient care. In this study, we aimed to determine the rate and reasons for UIA following elective surgeries in public facilities in Qatar.

UIA was defined as an admission to the intensive care unit (ICU) within 72 hours of anesthesia that was not anticipated during the pre-anesthesia assessment phase. A multicenter audit was conducted from January 1, 2021, to December 31, 2021, across five public hospitals in Qatar. UIA was identified from the electronic preoperative and postoperative anesthetic assessment notes and intraoperative notes.

Among the 2,087 ICU admissions, 42 (2.0%) were UIAs. Among the 42 patients, 57.1% were males, and the mean age was 41.83 ± 12.95 years. Most patients (64.3%) were classified as American Society of Anesthesiologists status II. The mean length of ICU stay was 2.60 ± 2.45 days. Most of the UIAs were surgery-related (54.8%), followed by anesthesia-related (26.2%) and medical-related (16.6%).

The rate of UIA in our study was 2%, corresponding to the wide range of incidence reported in the literature. The causes of UIA are multiple; however, our study showed that the rate of anesthesia-related UIAs was 26.2%, which is less than in most previous studies.

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