dc.contributor.author |
Skinner, D.L.
|
|
dc.contributor.author |
De Vasconcellos, K.
|
|
dc.contributor.author |
Wise, R.
|
|
dc.contributor.author |
Esterhuizen, T.M.
|
|
dc.contributor.author |
Fourie, C.
|
|
dc.contributor.author |
Mahomed, A. Goolam
|
|
dc.contributor.author |
Gopalan, P.D.
|
|
dc.contributor.author |
Joubert, I.
|
|
dc.contributor.author |
Kluyts, Hyla-Louise
|
|
dc.contributor.author |
Mathivha, L.R.
|
|
dc.contributor.author |
Mrara, Busisiwe
|
|
dc.contributor.author |
Pretorius, Jan P.
|
|
dc.contributor.author |
Richards, Guy A.
|
|
dc.contributor.author |
Smith, O.
|
|
dc.contributor.author |
Spruyt, M.G.L.
|
|
dc.contributor.author |
Pearse, R.M.
|
|
dc.contributor.author |
Madiba, T.E.
|
|
dc.contributor.author |
Biccard, Bruce McIure
|
|
dc.date.accessioned |
2017-07-31T09:24:30Z |
|
dc.date.available |
2017-07-31T09:24:30Z |
|
dc.date.issued |
2017-05 |
|
dc.description.abstract |
BACKGROUND. Appropriate critical care admissions are an important component of surgical care. However, there are few data describing
postoperative critical care admission in resource-limited low- and middle-income countries.
OBJECTIVE. To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical
care units in South Africa (SA).
METHODS. The SA Surgical Outcomes Study (SASOS) was a 7-day national, multicentre, prospective, observational cohort study of all
patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals. All
patients admitted to critical care units during this study were included for analysis.
RESULTS. Of the 3 927 SASOS patients, 255 (6.5%) were admitted to critical care units; of these admissions, 144 (56.5%) were planned, and
111 (43.5%) unplanned. The incidence of confirmed or strongly suspected infection at the time of admission was 35.4%, with a significantly
higher incidence in unplanned admissions (49.1 v. 24.8%, p<0.001). Unplanned admission cases were more frequently hypovolaemic, had
septic shock, and required significantly more inotropic, ventilatory and renal support in the first 48 hours after admission. Overall mortality
was 22.4%, with unplanned admissions having a significantly longer critical care length of stay and overall mortality (33.3 v. 13.9%, p<0.001).
CONCLUSION. The outcome of patients admitted to public sector critical care units in SA is strongly associated with unplanned admissions.
Adequate ‘high care-dependency units’ for postoperative care of elective surgical patients could potentially decrease the burden on critical
care resources in SA by 23%. This study was registered on ClinicalTrials.gov (NCT02141867). |
en_ZA |
dc.description.department |
Surgery |
en_ZA |
dc.description.librarian |
am2017 |
en_ZA |
dc.description.sponsorship |
SASA and the Vascular Association
of SA (VASSA). |
en_ZA |
dc.description.uri |
http://www.samj.org.za |
en_ZA |
dc.identifier.citation |
Skinner D.L., De Vasconcellos K., Wise R., Esterhuizen T.M., Fourie C., Mahomed A.G., Gopalan P.D., Joubert I., Kluyts H.-L., Mathivha L.R., Mrara B., Pretorius J.P., Richards G., Smith O., Spruyt M.G.L., Pearse R.M., Madiba T.E., Biccard B.M. 2017, 'Critical care admission of South African (SA) surgical patients : results of the SA surgical outcomes study', South African Medical Journal, vol. 107, no. 5, pp. 411-419. |
en_ZA |
dc.identifier.issn |
0256-9574 (print) |
|
dc.identifier.issn |
2078-5135 (online) |
|
dc.identifier.other |
10.7196/SAMJ.2017.v107i5.11455 |
|
dc.identifier.uri |
http://hdl.handle.net/2263/61528 |
|
dc.language.iso |
en |
en_ZA |
dc.publisher |
Health and Medical Publishing Group |
en_ZA |
dc.rights |
© 2017 Health & Medical Publishing Group. This article is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0). |
en_ZA |
dc.subject |
Surgical care |
en_ZA |
dc.subject |
Critical care |
en_ZA |
dc.subject |
Patients |
en_ZA |
dc.subject |
South Africa (SA) |
en_ZA |
dc.title |
Critical care admission of South African (SA) surgical patients : results of the SA surgical outcomes study |
en_ZA |
dc.type |
Article |
en_ZA |