Objective

Unplanned admissions to ITU following Thoracic Surgery is believed to be associated with increased morbidity and mortality. This has been shown to be a quality indicator in general surgical patients however has not been demonstrated in Thoracic patients. This study aims to examine the rate of unplanned admissions and explore short and midterm outcomes for these patients.

Methods

A total number of 1,629 patients had thoracic surgery from March 2013 to July 2015. All admissions to ITU were reviewed, causes for admission were analysed and outcomes identified. There were 142 (8.7%) admissions to ITU with 69 (4.2%) planned and 73 (4.5%) unplanned. The mean age (years) was 64.4±10.6 versus 65.1±11.7 (p= 0.709), male:female ratio 46:23 versus 45:28 (p=0.536) between planned and unplanned groups.

Results

The planned admissions were for pneumonectomy 19, oesophagogastrectomy 22, lobectomy (open/VATS) 10, others 18. The unplanned admissions were lobectomy (open/vats) 37 and others 36. The 30 day mortality was 8.7% versus 11.0% (p=0.654), the midterm mortality was 18.4% versus 17.8% (p=0.908) between planned and unplanned ITU admission groups. The overall mortality of unplanned admissions to ITU was 17.8% versus 2.4% in non-admitted patients.

Conclusion

Our results identify factors that increase the risks of unplanned admission to ITU post thoracic surgery. The overall mortality is significantly higher in the unplanned ITU group versus non admitted patients; however, planned admissions have similar higher mortality. Further research on the provision of ITU care for thoracic patients is warranted.