Factors predicting planned and unplanned postoperative intensive care unit (ICU) admissions- A Prospective Observational Study.

Peri-operative medicine is the patient-centred and value-based multidisciplinary perioperative care of surgical patients. Unplanned ICU admissions after surgery is a quality indicator of the perioperative management. Planned postoperative intensive care unit (ICU) admission will benefit high risk patients and it is important to triage patients accordingly. The prediction is multifactorial and can be categorised as preoperative, intraoperative and postoperative factors. However, some patients may need unplanned ICU admission because of unexpected intraoperative or postoperative complications.

The preoperative assessment can be done through various methods including questionnaires, formal and specialist assessment. Preoperative factors include age, body mass index and functional capacity of the patient, any significant past cardiac events or substance abuse; intraoperative factors like risk stratification of the surgery, haemodynamic stability status or any adverse perioperative event; postoperative factors include requirement of ventilatory assistance in PACU, haemodynamic instability or seizures in PACU.

The aim of this study will be selecting patient groups prior to surgery which will help in adequate allocation of intensive care and better intraoperative management, especially in resource limited health care settings. This will also emphasize the need for clinical decision support tools in PACU with regard to postoperative patient allocation and patient care.