Department of Anesthesiology, Resuscitation, and ICU, Osijek University Hospital Center, Osijek, Croatia.
Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
Acta Clin Croat. 2023 Jul;62(Suppl2):14-20. doi: 10.20471/acc.2023.62.s2.2.
The postoperative care unit at the Department of Urology has significantly improved treatment of patients undergoing surgical procedures and reduced admission of urologic patients to the Intensive Care Unit (ICU). We examined the characteristics of urologic patients, time on mechanical ventilation, most common complications, and mortality in the period from January 2017 to March 2022. A total of 84 admissions to ICU were recorded, accounting for 1.5% of all patients having undergone surgical, therapeutic or diagnostic interventions under general or regional anesthesia at the Department of Urology. The most common reasons for admission to ICU were respiratory failure (79 patients), hemodynamic instability, and bleeding. The median time on mechanical ventilation was 9.7 [2.4-58.2] hours in urology patients vs. 6 [3-14.7] hours in the rest of surgical ICU patients (p=0.058). Hypertension and renal failure were more common in urologic than in the rest of surgical ICU patients (p<0.05). The overall mortality of urologic patients was lower than in the rest of surgical ICU patients (10.7% vs. 18.99%, p=0.08) but the difference did not reach statistical significance. Independently of the lower mortality, improvements in the outcome of urologic patients admitted to the ICU are feasible. Early identification of patients at risk of infections, postoperative respiratory failure, cardiovascular incidents, and bleeding may further reduce mortality and improve outcomes.
泌尿科术后护理单元显著改善了接受手术治疗的患者的治疗效果,并减少了泌尿科患者入住重症监护病房(ICU)的人数。我们检查了 2017 年 1 月至 2022 年 3 月期间泌尿科患者的特点、机械通气时间、最常见的并发症和死亡率。共有 84 例 ICU 入院,占泌尿科接受全身或区域麻醉下手术、治疗或诊断性干预的所有患者的 1.5%。ICU 入院的最常见原因是呼吸衰竭(79 例)、血流动力学不稳定和出血。泌尿科患者机械通气中位数为 9.7 [2.4-58.2] 小时,而其余外科 ICU 患者为 6 [3-14.7] 小时(p=0.058)。高血压和肾衰竭在泌尿科患者中比在其余外科 ICU 患者中更为常见(p<0.05)。泌尿科患者的总体死亡率低于其余外科 ICU 患者(10.7%比 18.99%,p=0.08),但差异无统计学意义。独立于较低的死亡率,泌尿科患者入住 ICU 的预后改善是可行的。早期识别感染、术后呼吸衰竭、心血管事件和出血风险患者可能进一步降低死亡率并改善预后。