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Báo cáo y học: " Triage of high-risk surgical patients for intensive care"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Triage of high-risk surgical patients for intensive care. | Sobol and Wunsch Critical Care 2011 15 217 http ccforum.eom content 15 2 217 CRITICAL CARE REVIEW L_ Triage of high-risk surgical patients for intensive care Julia B Sobol and Hannah Wunsch This article is one of eleven reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2011 Springer Verlag and co-published as a series in Critical Care. Other articles in the series can be found online at http ccforum.com series annual. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http www.springer.com series 8901 Introduction Patients who undergo high-risk non-cardiac surgical procedures represent a large proportion of admissions to intensive care units ICUs in the developed world 1 . Ideally surgeons anesthesiologists and intensivists admitting surgical patients to ICUs target the patients who will benefit most from this highest level of postoperative care. However accurately identifying which patients are at high risk of complications or death after major surgery remains difficult. For example a recent study in the United Kingdom demonstrated that patients undergoing high-risk general surgical procedures comprised only 12.5 of surgical admissions to hospitals but over 80 of deaths with less than 15 of these high-risk patients admitted to the ICU postoperatively 2 . Postoperative outcomes are a result of the complex interplay between the exact general surgical procedure performed the previous health of the patient and specific intra- and postoperative events. Outcomes may also be influenced by aspects of the particular healthcare system such as the surgical procedure volume at different hospitals 3 as well as care options such as the availability and suitable use of intensive care beds. Appropriate triage of patients to intensive care postoperatively may have a large impact on outcomes after non-cardiac surgery. This chapter reviews the patient factors and scoring systems developed to .