Effects of closed- versus open-system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications: a single-center retrospective study in Korea
Background In this study, we aimed to compare the in-hospital mortality of patients with cancer who experienced acute abdominal complications that required emergent surgery in open (treatment decisions made by the primary attending physician of the patient's admission department) versus closed...
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| Language: | English |
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Korean Society of Critical Care Medicine
2024-11-01
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| Series: | Acute and Critical Care |
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| Online Access: | http://www.accjournal.org/upload/pdf/acc-2024-00808.pdf |
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| author | Jae Hoon Lee Jee Hee Kim Ki Ho You Won Ho Han |
| author_facet | Jae Hoon Lee Jee Hee Kim Ki Ho You Won Ho Han |
| author_sort | Jae Hoon Lee |
| collection | DOAJ |
| description | Background In this study, we aimed to compare the in-hospital mortality of patients with cancer who experienced acute abdominal complications that required emergent surgery in open (treatment decisions made by the primary attending physician of the patient's admission department) versus closed (treatment decisions made by intensive care unit [ICU] intensivists) ICUs. Methods This retrospective, single-center study enrolled patients with cancer admitted to the ICU before or after emergency surgery between November 2020 and September 2023. Univariate and logistic regression analyses were conducted to explore the associations between patient characteristics in the open and closed ICUs and in-hospital mortality. Results Among the 100 patients (open ICU, 49; closed ICU, 51), 23 died during hospitalization. The closed ICU group had higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores, vasopressor use, mechanical ventilation, and preoperative lactate levels and a shorter duration from diagnosis to ICU admission, surgery, and antibiotic administration than the open ICU group. Univariate analysis linked in-hospital mortality and APACHE II score, postoperative lactate levels, continuous renal replacement therapy (CRRT), and mechanical ventilation. Multivariate analysis revealed that in-hospital mortality rate increased with CRRT use and was lower in the closed ICU. Conclusions Compared to an open ICU, a closed ICU was an independent factor in reducing in-hospital mortality through prompt and appropriate treatment. |
| format | Article |
| id | doaj-art-7d869d7b277348e9b3caccf01d7b7ff0 |
| institution | DOAJ |
| issn | 2586-6052 2586-6060 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj-art-7d869d7b277348e9b3caccf01d7b7ff02025-08-20T03:06:02ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602024-11-0139455456410.4266/acc.2024.008081560Effects of closed- versus open-system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications: a single-center retrospective study in KoreaJae Hoon Lee0Jee Hee Kim1Ki Ho You2Won Ho Han3 Department of Critical Care Medicine, National Cancer Center, Goyang, Korea Department of Anesthesiology and Pain Medicine, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea Center for Colorectal Cancer, National Cancer Center, Goyang, Korea Department of Critical Care Medicine, National Cancer Center, Goyang, KoreaBackground In this study, we aimed to compare the in-hospital mortality of patients with cancer who experienced acute abdominal complications that required emergent surgery in open (treatment decisions made by the primary attending physician of the patient's admission department) versus closed (treatment decisions made by intensive care unit [ICU] intensivists) ICUs. Methods This retrospective, single-center study enrolled patients with cancer admitted to the ICU before or after emergency surgery between November 2020 and September 2023. Univariate and logistic regression analyses were conducted to explore the associations between patient characteristics in the open and closed ICUs and in-hospital mortality. Results Among the 100 patients (open ICU, 49; closed ICU, 51), 23 died during hospitalization. The closed ICU group had higher Acute Physiology and Chronic Health Evaluation (APACHE) II scores, vasopressor use, mechanical ventilation, and preoperative lactate levels and a shorter duration from diagnosis to ICU admission, surgery, and antibiotic administration than the open ICU group. Univariate analysis linked in-hospital mortality and APACHE II score, postoperative lactate levels, continuous renal replacement therapy (CRRT), and mechanical ventilation. Multivariate analysis revealed that in-hospital mortality rate increased with CRRT use and was lower in the closed ICU. Conclusions Compared to an open ICU, a closed ICU was an independent factor in reducing in-hospital mortality through prompt and appropriate treatment.http://www.accjournal.org/upload/pdf/acc-2024-00808.pdfacute abdomencritical care outcomesin-hospital mortalityintensive care units (icus)neoplasms |
| spellingShingle | Jae Hoon Lee Jee Hee Kim Ki Ho You Won Ho Han Effects of closed- versus open-system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications: a single-center retrospective study in Korea Acute and Critical Care acute abdomen critical care outcomes in-hospital mortality intensive care units (icus) neoplasms |
| title | Effects of closed- versus open-system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications: a single-center retrospective study in Korea |
| title_full | Effects of closed- versus open-system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications: a single-center retrospective study in Korea |
| title_fullStr | Effects of closed- versus open-system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications: a single-center retrospective study in Korea |
| title_full_unstemmed | Effects of closed- versus open-system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications: a single-center retrospective study in Korea |
| title_short | Effects of closed- versus open-system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications: a single-center retrospective study in Korea |
| title_sort | effects of closed versus open system intensive care units on mortality rates in patients with cancer requiring emergent surgical intervention for acute abdominal complications a single center retrospective study in korea |
| topic | acute abdomen critical care outcomes in-hospital mortality intensive care units (icus) neoplasms |
| url | http://www.accjournal.org/upload/pdf/acc-2024-00808.pdf |
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