초록접수 현황
| 20F-156 | 구연 발표 |
Prevalence and mortality of intensive care unit admission after initial recovery from major pulmonary resection
Wan Jin Hwang, Beatrice Chia-Hui Shih, Soyoung Lee, Woohyun Jung, Jae Hyun Jeon, Sukki Cho, Kwhanmien Kim, Sanghoon Jheon, Yoohwa Hwang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul University College of Medicine, Seoul, Republic of Korea
Purpose : This study aimed to describe the prevalence and outcome of patient with major pulmonary resection who required intensive care unit (ICU) admission after initial recovery, and to analyzed preoperative and perioperative associated with mortality.
Methods : We retrospectively reviewed the case records of 3839 patients who underwent major pulmonary resection including lobectomy, bilobectomy and pneumonectomy at our institution from January 2010 to April 2020. 73 (1.9%) of those patients required ICU admission after initial recovery. Preoperative and perioperative information including ICU-specific variables and outcome data were analyzed after patients were classified as either survivors or non-survivors.
Results : The patient group included 64 men (87.7%) with a mean age of 69.2 years. Pathologic diagnosis was malignancy in 89.1% of patients. Minimally invasive approaches were performed in 76.7%. The most common cause for ICU admission was pulmonary complication (n=51, 69.9%). In hospital mortality was 19.2% (n=14) and all were male. The non-survivor group had more underlying pulmonary or renal disease (p=0.01, p=0.04), longer ICU admission intervals after surgery (p=0.04), higher APACHE IV score (p=0.02). In multivariable analysis, underlying IPF (HR 43.4; 95% CI 2.4-769.5) and adjusted the extracorporeal support including mechanical ventilator, CRRT and ECMO (HR 67.3; 95% CI 1.1-4029.2) were the independent risk factors for in hospital mortality.
Conclusion : Underlying IPF and higher APACHE score were the independent risk factors for in-hospital mortality in patient who required ICU admission after pulmonary resection. The extracorporeal supports lead to the fatal results, so more intensive care needs in those patients.
Methods : We retrospectively reviewed the case records of 3839 patients who underwent major pulmonary resection including lobectomy, bilobectomy and pneumonectomy at our institution from January 2010 to April 2020. 73 (1.9%) of those patients required ICU admission after initial recovery. Preoperative and perioperative information including ICU-specific variables and outcome data were analyzed after patients were classified as either survivors or non-survivors.
Results : The patient group included 64 men (87.7%) with a mean age of 69.2 years. Pathologic diagnosis was malignancy in 89.1% of patients. Minimally invasive approaches were performed in 76.7%. The most common cause for ICU admission was pulmonary complication (n=51, 69.9%). In hospital mortality was 19.2% (n=14) and all were male. The non-survivor group had more underlying pulmonary or renal disease (p=0.01, p=0.04), longer ICU admission intervals after surgery (p=0.04), higher APACHE IV score (p=0.02). In multivariable analysis, underlying IPF (HR 43.4; 95% CI 2.4-769.5) and adjusted the extracorporeal support including mechanical ventilator, CRRT and ECMO (HR 67.3; 95% CI 1.1-4029.2) were the independent risk factors for in hospital mortality.
Conclusion : Underlying IPF and higher APACHE score were the independent risk factors for in-hospital mortality in patient who required ICU admission after pulmonary resection. The extracorporeal supports lead to the fatal results, so more intensive care needs in those patients.
첨부파일 : Flow & tables.pptx
책임저자: Yoohwa Hwang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul University College of Medicine, Seoul, Republic of Korea
발표자: Wan Jin Hwang, E-mail : 82375@snubh.org