The impact of abdominal aortic aneurysm surgery on intensive care unit resources in an Irish tertiary centre.

BACKGROUND

The potential impact of surgical service reconfiguration on intensive care unit (ICU) resources needs to be assessed.

AIMS

To determine the resources required to provide post-operative ICU care to patients undergoing open abdominal aortic aneurysm (AAA) repair or endovascular aneurysm repair (EVAR) at a specialist centre in the HSE South area

METHODS

For 198 patients, we calculated: (1) ICU bed-days; (2) organ support required; and (3) monetary cost of ICU care.

RESULTS

In total, 82.8% (101/122) of patients undergoing open AAA repair required post-operative ICU care (52 emergency and 49 elective). Emergency cases required more ICU bed-days (median 4.2 vs. 1.9, p<0.0005) and were more likely to require ventilation (odds ratio, OR 11.7, p<0.0001), inotropes (OR 3.1, p=0.01) or enteral nutrition (OR 23.3, p<0.0001). Mean cost per patient was €3,956 for elective cases and €16,419 for emergency cases. No patient required ICU admission after EVAR (n=76).

CONCLUSIONS

Open AAA surgery places significant demands on ICU resources. The planned reconfiguration of surgical services in Ireland must provide for parallel investment in ICU facilities and expertise.