Critical care admission of South African (SA) surgical patients : results of the SA surgical outcomes study

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dc.contributor.authorSkinner, David Leeen_ZA
dc.contributor.authorDe Vasconcellos, Kimen_ZA
dc.contributor.authorWise, Roberten_ZA
dc.contributor.authorEsterhuizen, Tonya Marianneen_ZA
dc.contributor.authorFourie, Cateen_ZA
dc.contributor.authorMahomed, Akhter Goolamen_ZA
dc.contributor.authorGopalan, P. Deanen_ZA
dc.contributor.authorJoubert, Ivanen_ZA
dc.contributor.authorKluyts, Hyla-Louiseen_ZA
dc.contributor.authorMathivha, L. Rudoen_ZA
dc.contributor.authorMrara, Busisiween_ZA
dc.contributor.authorPretorius, Jan P.en_ZA
dc.contributor.authorRichards, Guyen_ZA
dc.contributor.authorSmith, Ollieen_ZA
dc.contributor.authorSpruy, Maryke Geertruida Louiseen_ZA
dc.contributor.authorPearse, Rupert M.en_ZA
dc.contributor.authorMadiba, Thandinkosi E.en_ZA
dc.contributor.authorBiccard, Bruce M.en_ZA
dc.date.accessioned2019-02-28T12:39:49Z
dc.date.available2019-02-28T12:39:49Z
dc.date.issued2017
dc.descriptionCITATION: Skinner, D. L., et al. 2017. Critical care admission of South African (SA) surgical patients : results of the SA surgical outcomes Study. South African Medical Journal, 107(5):411-419, doi:10.7196/SAMJ.2017.v107i5.11455.
dc.descriptionThe original publication is available at http://www.samj.org.za/index.php/samj
dc.description.abstractBackground. Appropriate critical care admissions are an important component of surgical care. However, there are few data describing postoperative critical care admission in resource-limited low- and middle-income countries. Objective. To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical care units in South Africa (SA). Methods. The SA Surgical Outcomes Study (SASOS) was a 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals. All patients admitted to critical care units during this study were included for analysis. Results. Of the 3 927 SASOS patients, 255 (6.5%) were admitted to critical care units; of these admissions, 144 (56.5%) were planned, and 111 (43.5%) unplanned. The incidence of confirmed or strongly suspected infection at the time of admission was 35.4%, with a significantly higher incidence in unplanned admissions (49.1 v. 24.8%, p<0.001). Unplanned admission cases were more frequently hypovolaemic, had septic shock, and required significantly more inotropic, ventilatory and renal support in the first 48 hours after admission. Overall mortality was 22.4%, with unplanned admissions having a significantly longer critical care length of stay and overall mortality (33.3 v. 13.9%, p<0.001). Conclusion. The outcome of patients admitted to public sector critical care units in SA is strongly associated with unplanned admissions. Adequate ‘high care-dependency units’ for postoperative care of elective surgical patients could potentially decrease the burden on critical care resources in SA by 23%. This study was registered on ClinicalTrials.gov (NCT02141867).en_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/11880
dc.description.versionPublisher's version
dc.format.extent9 pages
dc.identifier.citationSkinner, D. L., et al. 2017. Critical care admission of South African (SA) surgical patients : results of the SA surgical outcomes Study. South African Medical Journal, 107(5):411-419, doi:10.7196/SAMJ.2017.v107i5.11455
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.2017.v107i5.11455
dc.identifier.urihttp://hdl.handle.net/10019.1/105494
dc.language.isoen_ZAen_ZA
dc.publisherHealth and Medical Publishing Group
dc.rights.holderAuthors retain copyright
dc.subjectSurgical intensive careen_ZA
dc.subjectIntensive care unitsen_ZA
dc.subjectIntensive care units -- Admission and dischargeen_ZA
dc.titleCritical care admission of South African (SA) surgical patients : results of the SA surgical outcomes studyen_ZA
dc.typeArticleen_ZA
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