Epidemiology and outcomes of non-cardiac surgical patients in Brazilian intensive care units

Abstract

Due to the dramatic medical breakthroughs and an increas ingly ageing population, the proportion of patients who are at risk of dying fol lowing surgery is increasing over time. The aim of this study was to evaluate the outcomes and the epidemiology of non cardiac surgical patients admitted to the intensive care unit. Methods: A multicenter, prospec tive, observational, cohort study was carried out in 21 intensive care units. A total of 885 adult surgical patients ad mitted to a participating intensive care unit from April to June 2006 were eval uated and 587 patients were enrolled. Exclusion criteria were trauma, cardiac, neurological, gynecologic, obstetric and palliative surgeries. The main outcome measures were postoperative complica tions and intensive care unit and 90- day mortality rates. Results: Major and urgent surgeries were performed in 66.4% and 31.7% of the patients, respectively. The inten sive care unit mortality rate was 15%, and 38% of the patients had postopera tive complications. The most common complication was infection or sepsis (24.7%). Myocardial ischemia was di agnosed in only 1.9% of the patients. A total of 94 % of the patients who died after surgery had co-morbidities at the time of surgery (3.4 ± 2.2). Multiple organ failure was the main cause of death (53%). Conclusion: Sepsis is the predomi nant cause of morbidity in patients un dergoing non-cardiac surgery. In this pa tient population, multiple organ failure prevailed as the most frequent cause of death in the hospital.