Chandra M, Wagner W H, Shabot M M
Cedars-Sinai Research Institute, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Am Surg. 1995 Oct;61(10):904-7.
The authors analyzed 632 consecutive, nontrauma Surgical Intensive Care Unit (SICU) admissions after infra-inguinal arterial surgery over a 3-year period (4/89-3/92) for the need for postoperative SICU care. Group I consisted of 122 patients (58 males, 64 females) with at least one absolute indication for SICU care, including mechanical ventilation, pulmonary artery, catheter monitoring, or intravenous infusion of vasoactive or antiarrythmic drugs. Group II comprised 510 patients (275 males, 235 females) without an absolute indication for SICU care. Data collected included age, first day ICU severity of illness scores (Simplified Acute Physiology Score [SAPS] and Quantitative Therapeutic Intervention Scoring System [QTISS]), preoperative length of stay (LOS), SICU LOS, hospital LOS, and mortality. Ten patients (8.2%) in Group I and ten patients (2.0%) in Group II died in the SICU (P = 0.0004). There was no significant difference in the age of Group I and Group II patients, but Group I patients had a significantly longer preoperative LOS (6.1 +/- 0.7 vs 3.2 +/- 0.3 days, P < 0.0005). In Group II patients there were significant correlations between patient age and postoperative death, as well as between preoperative LOS and SICU LOS > 1 day. Patient age > or = 80 years and preoperative LOS > 3 days are significant preoperative correlates of the need for SICU care following infra-inguinal arterial surgery in patients who do not have an absolute indication for such care.
作者分析了在3年期间（1989年4月至1992年3月）腹股沟下动脉手术后连续632例非创伤性入住外科重症监护病房（SICU）的患者，以确定术后SICU护理的需求。第一组由122例患者组成（58例男性，64例女性），这些患者至少有一项入住SICU的绝对指征，包括机械通气、肺动脉导管监测或静脉输注血管活性药物或抗心律失常药物。第二组包括510例患者（275例男性，235例女性），他们没有入住SICU的绝对指征。收集的数据包括年龄、入住ICU第一天的疾病严重程度评分（简化急性生理学评分[SAPS]和定量治疗干预评分系统[QTISS]）、术前住院时间（LOS）、SICU住院时间、医院住院时间和死亡率。第一组中有10例患者（8.2%）和第二组中有10例患者（2.0%）在SICU死亡（P = 0.0004）。第一组和第二组患者的年龄没有显著差异，但第一组患者的术前住院时间明显更长（6.1±0.7天对3.2±0.3天，P < 0.0005）。在第二组患者中，患者年龄与术后死亡之间以及术前住院时间与SICU住院时间>1天之间存在显著相关性。对于没有此类护理绝对指征的患者，年龄≥80岁和术前住院时间>3天是腹股沟下动脉手术后需要SICU护理的重要术前相关因素。
