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Title: Characteristics and outcomes of surgical patients admitted to an overnight intensive recovery unit: A retrospective observational study.
Austin Authors: Costa-Pinto, Rahul;Yanase, Fumitaka ;Kennedy, Lucy M;Talbot, Lachie J;Flanagan, Jeremy Pm;Opdam, Helen I ;Ellard, Louise M;Bellomo, Rinaldo ;Jones, Daryl A 
Affiliation: Data Analytics Research and Evaluation (DARE) Centre
Intensive Care
Department of Critical Care, University of Melbourne, Parkville, Australia
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
Melbourne Medical School, University of Melbourne, Parkville, Australia
Issue Date: 2023
Date: 2022
Publication information: Anaesthesia and Intensive Care 2023; 51(1)
Abstract: Postoperative 'enhanced care' models that sit between critical care and ward-based care may allow for more cost-effective and efficient utilisation of resources for high-risk surgical patients. In this retrospective observational study, we describe an overnight intensive recovery model in a tertiary hospital, termed 'recovery high dependency unit', and the characteristics, treatment, disposition at discharge and in-hospital outcomes of patients admitted to this unit. We included all adult patients (≥18 years) admitted to the recovery high dependency unit for at least one hour between July 2017 and June 2020. Over this three-year period, 1257 patients were included in the study. The median length of stay in the recovery high dependency unit was 12.6 (interquartile range 9.1-15.9) hours and the median length of hospital stay was 8.3 (interquartile range 5.0-17.3) days. Hospital discharge data showed that 1027 (81.7%) patients were discharged home and that 37 (2.9%) patients died. Non-invasive ventilation was delivered to 59 (4.7%) patients and 290 (23.1%) required vasopressor support. A total of 164 patients (13.0%) were admitted to the intensive care unit following their recovery high dependency unit admission. Of the 1093 patients who were discharged to the ward, 70 patients (6.4%) had a medical emergency team call within 24 hours of discharge from the recovery high dependency unit. In this study of a recovery high dependency unit patient cohort, there was a relatively low need for intensive care unit admission postoperatively and a very low incidence of medical emergency team calls post-discharge to the ward. Other institutions may consider the introduction and evaluation of this model in the care of their higher risk surgical patients.
DOI: 10.1177/0310057X221105299
ORCID: 0000-0003-4007-7849
Journal: Anaesthesia and intensive care
PubMed URL: 36217293
ISSN: 0310-057X
Type: Journal Article
Subjects: Enhanced care
high dependency unit
perioperative care
postoperative complications
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