A prospective study of clinical and demographic profile of postoperative patients admitted in intensive care units of GMC, Srinagar (SMHS & SSH:ICU).

Background: Clinico-demographic profile, pre-anesthetic illness of patients, surgical procedure and anaesthetic technique, experience of surgeon and anaesthetist and duration of anaesthesia play a vital role in the development of peri-operative complications and subsequent admission to intensive care unit (ICU). Over 40% admissions in ICU are of postoperative patients. Aim: To study the clinical and demographic profile, reason for admission, course and outcome of postoperative patients, in our intensive care unit. Methods: Admission profile of 135 patients in the Intensive Care Units of SMHS and SSH hospital (Associated hospital of GMC Srinagar) was observed over a period of one and half year belonging to various surgical specialities, both elective and emergency admissions were included in the study. Evaluation was done under demographic and clinical parameters. Statistical Analysis: The recorded data was compiled and entered in a spreadsheet (Microsoft Excel) and then exported to data editor of SPSS Version 20.0 (SPSS Inc., Chicago, Illinois, USA). Continuous variables were expressed as Mean±SD and categorical variables were summarized as frequencies and percentages. Graphically the data was presented by bar and pie diagrams. Chisquare test or Fisher's exact test, whichever appropriate, was applied for comparing categorical variables. A p value of less than 0.05 was considered statistically significant. Results: The age of study patients vary from 20 to 70 years with mean age of distribution was 47.2±20.97 years. Maximum numbers of study patients were between the age of 41 and 49 years. Highest numbers of patients (41.5%) were post-surgical with exploratory laparotomy followed by Craniotomy with tumor decompression (12.6%). 58.5% were emergency surgeries while as 41.5% were elective cases. Main reason for ICU admission was haemodynamic unstability (37.8%) followed by Metabolic acidosis with hemodynamic unstability (15.6%) among the study population. 52.6% of patients admitted to our ICU during study period belong to planned group, among which 80.4% were elective surgical patients and 19.6% emergency surgical patients, while as 47.4% of the ICU patients were unplanned, among which 19.6% were elective surgical patients and 67.1% were emergency surgical patients. Mortality in planned group was 35.2% (25/71) and in unplanned group it was 39.1% (25/64). The overall mortality rate was 37.0%. Conclusion: Thorough preoperative evaluation and preoperative optimization of patients whenever possible can reduce the incidence of unplanned admission to ICU. Early recognition of complications, timely intervention, and timely intensive care admission and monitoring are essential to improve outcomes. [ABSTRACT FROM AUTHOR]