Routine Intensive Care Unit Admission After Pancreaticoduodenectomy: Is it Worth it?
Recommended Citation
Nassif G, Gartrelle K, Kwon H, Shah R, Cools KS, Steffes C, Kwon DS. Routine Intensive Care Unit Admission After Pancreaticoduodenectomy: Is it Worth it?. Pancreas 2024; 53(1):e116.
Document Type
Conference Proceeding
Publication Date
1-1-2024
Publication Title
Pancreas
Abstract
Background: Routine intensive care unit admission (rICUa) is still being utilized after pancreaticoduodenectomy (PD) given the high rates of post-operative morbidity. However, the impact of rICUa on post-operative outcomes is unclear. We hypothesized that rICUa after PD might increase costs of care without significantly improving post-operative outcomes. Methods: Retrospective analysis of our prospectively maintained pancreatic cancer database was conducted. Patients who underwent PD between 2018 and 2022 were stratified by post-operative rICUa and regular ward admission (RWa). Post-operative complications, intensive care unit readmission, lengths of stay, reoperation, and 30- and 90-day outcomes were compared between the two groups. Results: 175 patients underwent PD between 2018 and 2022 at our institution. 62.9 % (N = 110) had a rICUa post-operatively, while 37.1% (N = 65) had a RWa. Demographics, comorbidities, disease pathologies, and intra-operative variables were similar between the two groups. There were no significant differences in major post-operative complications, pancreas-specific complications, and intensive care unit readmissions between the two groups. Patients with rICUa had significantly longer lengths of stay than those with RWa (Wilcoxon Rank Sum Test p = 0.024). RWa patients had significantly more 30-day emergency department visits (15.4% versus 4.5%, p = 0.013). Otherwise, rates of 30- and 90-day emergency department presentation, hospital readmission, reoperation, and mortality were similar between the two groups. Conclusions: Patients with rICUa and RWa had similar rates of morbidity and mortality post PD. Our data suggests that rICUa after PD might increase healthcare resource utilization and costs without improving post-operative outcomes. ICU admission should be considered on a case-by-case basis and tailored to patients' demographics, comorbidities, and intra-operative events.
Volume
53
Issue
1
First Page
e116
