Abstract

ALVAREZ-MALDONADO, Pablo et al. Thoracic versus non-thoracic emergency surgery: Outcomes in a Respiratory Intensive Care Unit. Rev. Asoc. Mex. Med. Crít. Ter. Intensiva [online]. 2015, vol.29, n.3, pp.133-137. ISSN 0187-8433.

Purpose: To compare the outcomes in a Respiratory Intensive Care Unit (RICU) between thoracic and non-thoracic emergency surgery. Material and methods: Retrospective and transversal cohort study. All patients admitted to a RICU who underwent emergency surgery between March of 2010 and October of 2014 were included. Results: In the study period, emergency surgery was the reason for admission in 126 patients (thoracic surgery in 70; non-thoracic surgery in 56). Diagnoses of thoracic surgery patients were: mediastinitis (81.5%), penetrating thoracic wound (8.6%), empyema (7.1%), and other (2.8%). Diagnoses of non-thoracic surgery patients were: intestinal perforation (55.4%), appendicitis/cholecystitis (14.3%), mesenteric thrombosis (8.9%), intestinal occlusion (7.1%), abdominopelvic fasciitis (7.1%), and other (7.2%). Sex did not differed among groups (woman 30% versus 41%, p 0.27); but, a difference in age was observed (39.4 ± 11.6 versus 55 ± 16.4 years, p < 0.001), as well as in Simplified Acute Physiology Score 3 (36 ± 11 versus 59 ± 17, p < 0.001), Sequential Organ Failure Assessment score (3.4 ± 3.5 versus 7.9 ± 4.9, p < 0.001), mean days on mechanical ventilation (5.9 ± 5.2 versus 11.5 ± 12.1, p < 0.001) and mortality in the intensive care unit (21.4% versus 57.1%, p < 0.001). There was no difference in the length of stay in intensive care (9.4 ± 6.6 versus 12.6 ± 13.8, p 0.08). Conclusions: When comparing thoracic versus non-thoracic emergency surgery patients in the RICU, non-thoracic surgery patients were older, had worst prognosis, spend more resources and had three times more mortality compared to thoracic surgery patients.

Keywords : Thoracic surgery; emergency surgery; Intensive Care Unit.