02 June 2006

Major UK study shows over 80% of high-risk patients may not be adequately treated after surgery

Researchers call for better identification of high-risk patients prior to surgery.

Eighty-five per cent of patients known to be at risk of complications and death following surgery may not receive appropriate post-operative care according to a paper published today in the open access journal Critical Care.

Results of a six year study, lead by Dr Rupert Pearse of Queen Mary's School of Medicine and Dentistry, reveal that only 15% of patients known to have a high mortality risk following surgery - older patients, patients with multiple medical conditions or those undergoing complicated procedures - are transferred to intensive care units (ICUs) so they can receive optimal post-operative care.

Dr Pearse - with colleagues from the Intensive Care National Audit & Research Centre, (ICNARC), CHKS Ltd and St George's Hospital - analysed data on patients who had been admitted for surgical procedures or to ICUs in 94 NHS hospitals across the UK between January 1999 and October 2004.

The study confirmed the existence of a large population of high-risk general surgical patients accounting for around 13% of surgical procedures but more than 80% of deaths. The mortality rate for these patients was 12.3%. Results show that only 15% of these high-risk patients were admitted to ICUs after their operation suggesting inadequate provision of critical care resources within the NHS.

Pearse et al. concluded that better identification of high-risk patients is needed prior to surgery if the NHS is to overcome the currently significant challenge of reducing mortality following major surgery.

Rupert Pearse said: "This study when placed alongside other evidence does suggest that not enough high-risk surgical patients are admitted to Intensive Care. We need to find better ways of identifying these patients and making sure they receive the best possible care."

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Article:
Identification and characterisation of the high-risk surgical population in the United Kingdom
Rupert M Pearse, David A Harrison, Philip James, David Watson, Charles Hinds, Andrew Rhodes, R Michael Grounds and E David Bennett
Critical Care 2006, 10:R81 (2 June 2006) doi:10.1186/cc4928

Journal website:
http://ccforum.com/

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