Outcomes of Postoperative General Surgery Patients Requiring Mechanical Ventilation: A Prospective Observational Study

TL;DR

This study examines outcomes of general surgery patients needing mechanical ventilation, identifying risk factors that can help improve ICU care and survival rates.

Contribution

The study identifies clinical biomarkers and scoring systems that predict mortality in postoperative surgical patients requiring mechanical ventilation.

Findings

59 out of 92 patients died within 30 days of surgery.

Non-survivors had higher rates of ventilator-associated pneumonia and multiple organ dysfunction syndrome.

qSOFA ≥ 2 and ASA > 3 scores were significantly linked to mortality and complications.

Abstract

Background: By identifying the risk factors that contribute to complications and difficulties in postoperative extubation, this study provides insights that can refine ICU strategies, guide clinical decisions, and ultimately enhance outcomes for surgical patients on mechanical ventilation. This study aimed to evaluate the postoperative outcomes of patients requiring mechanical ventilation in general surgery.

Methods: This single-centre, hospital-based, prospective observational study included elective and emergency general surgery postoperative patients aged 18 years or older who required postoperative mechanical ventilation. The collected data included demographics, American Society of Anaesthesiologists scores (ASA), quick Sepsis-Related Organ Failure Assessment scores (qSOFA), Acute Physiology and Chronic Health Evaluation II scores (APACHE II), procalcitonin trends, and postoperative complications. The primary objective was to describe outcomes in patients requiring mechanical ventilation, with a focus on 30-day in-hospital mortality.

Results: A total of 92 patients were enrolled during the study period, with 89 admitted to the ICU following emergency surgery and three after elective surgery. Within 30 days of surgery, mortality occurred in 59 patients, while 33 survived. The incidence of ventilator-associated pneumonia and multiple organ dysfunction syndrome was significantly greater among non-survivors than among survivors. Both qSOFA ≥ 2 and ASA > 3 scores were significantly associated with ventilator-associated pneumonia, multi-organ dysfunction syndrome, and 30-day mortality.

Conclusion: Our study underscores the importance of clinical biomarkers and scoring systems, including qSOFA, APACHE II, international normalised ratio (INR), albumin, and procalcitonin in predicting mortality and guiding management strategies for general surgery patients requiring mechanical ventilation.