Evidence map›Paper›PMID 28439646›Full record

ArticleIntensive care medicine2017

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries.

Brennan C Kahan, Desponia Koulenti, Kostoula Arvaniti, Vanessa Beavis, Douglas Campbell, Matthew Chan, Rui Moreno, Rupert M Pearse, International Surgical Outcomes Study (ISOS) group

Registry-linked trialAbstract readEvaluation StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Intensive care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05626153 (Effects of Anesthesia Quality Improvement on Outcomes of Patients With Planned ICU Admission), which is not on this map. Cited by 48 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05626153 nacompletednot on this mapstarted 2023, after this paper: background citation

Effects of Anesthesia Quality Improvement on Outcomes of Patients With Planned ICU Admission: a Prospective Pre-post Intervention Study

TypeinterventionalSponsorPeking University First HospitalRan2023 to 2024Enrolled1,500ConditionsAnesthesia, Extubation, Intensive Care Unit, Postoperative ComplicationsArmsRoutine anesthesia care, Improved anesthesia care
3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  11. Intensive care utilisation after elective surgery in Australia and New Zealand: A point prevalence study.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Brennan C KahanQueen Mary University of London, London, E1 2AT, UK.
Desponia KoulentiAttikon University Hospital, Athens, Greece.
Kostoula ArvanitiPapageorgiou General Hospital, Thessaloniki, Greece.
Vanessa BeavisAuckland City Hospital, Auckland, New Zealand.
Douglas CampbellAuckland City Hospital, Auckland, New Zealand.
Matthew ChanChinese University of Hong Kong, Sha Tin, Hong Kong.
Rui MorenoHospital de São José, Centro Hospitalar de Lisboa Central, Lisboa, Lisbon, Portugal.
Rupert M PearseQueen Mary University of London, London, EC1M 6BQ, UK. r.pearse@qmul.ac.uk.ORCID http://orcid.org/0000-0002-4373-5934
International Surgical Outcomes Study (ISOS) group

Funding

Department of Health RP_2014-04-022
6 · The paper itself

Abstract

purposeAs global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality.

methodsPlanned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests.

results44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10-5.21]; p < 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings.

conclusionsWe did not identify any survival benefit from critical care admission following surgery.

Indexed as

AdultElective Surgical ProceduresFemaleHospitalizationHumansIntensive Care UnitsLength of StayLogistic ModelsMaleMiddle AgedPerioperative CarePostoperative PeriodProspective StudiesCritical care/utilisationPostoperative care/methodsPostoperative care/statistics and numerical dataSurgical procedures, operative/mortality

Identifiers

PMID28439646

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.