Assessing Postoperative Prolonged Length of Stay in the Intensive Care Unit.

Kate, D. (Dennis) ten (2014) Assessing Postoperative Prolonged Length of Stay in the Intensive Care Unit. thesis, Medicine.

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Abstract

INTRODUCTION In intensive care units (ICU’s) all over the world patients are admitted to recover from large surgical procedures. Till now, postoperative prolonged length of stay (LoS) on ICU’s has not been thoroughly researched. The first goal of this research is to decipher and categorize the causes of elective postoperative prolonged LoS in ICU’s of the Academical Medical Centre of Groningen. The second goal of this thesis is to figure out if postoperative relative adrenal insufficiency is a probable cause of haemodynamical reasons for prolonged LoS. METHODS A cohort study was set up. All patients admitted to the ICU after elective surgery (ages 18+) were included. LoS and cortisol levels were monitored. When a patient was admitted for more than one night, the reason was noted. RESULTS 18.3% of patients had prolonged LoS. Chi-square testing showed neurosurgery was associated with less prolonged LoS (p < 0.001). Due to the relative small group sizes, the power of comparing reasons for prolonged LoS per type of surgery was low, there was no significant difference (p = 0.263). Looking farther into the actual LoS, it turned out patients with haemodynamical problems generally stayed shorter. Cortisol levels weren’t the same across the types of surgery (p < 0.001) and reasons (p = 0.004), complications and intraoperative reasons had a significantly higher mean cortisol. DISCUSSION In the ICU of the Academical Medical Centre of Groningen most reasons for prolonged LoS are attributed to perioperative surgical or anesthetic problems. For thorough identification of other reasons, more patients need to be included in the research. Relative adrenal insufficiency doesn’t seem to play a clear role in the onset of prolonged LoS due to haemodynamical issues, but needs better testing.

Item Type:	Thesis (Thesis)
Supervisor name:	Zijlstra, prof. dr. J.G.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:56
Last Modified:	25 Jun 2020 10:56
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1689

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