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Статті в журналах з теми "Acute surgical unit"

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Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 28 січня 2023

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1

Page, Dean E., Dilshad Dooreemeah, and Dhan Thiruchelvam. "Acute surgical unit: the Australasian experience." ANZ Journal of Surgery 84, no. 1-2 (November 28, 2013): 25–30. http://dx.doi.org/10.1111/ans.12473.

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2

Von Conrady, Dora, Saud Hamza, Dieter Weber, Koorush Kalani, Krishna Epari, Marina Wallace, and David Fletcher. "The acute surgical unit: improving emergency care." ANZ Journal of Surgery 80, no. 12 (October 1, 2010): 933–36. http://dx.doi.org/10.1111/j.1445-2197.2010.05490.x.

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3

Kinnear, Ned, Eliza Bramwell, Alannah Frazzetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, and James Moore. "Acute surgical unit improves outcomes in appendicectomy." ANZ Journal of Surgery 89, no. 9 (April 15, 2019): 1108–13. http://dx.doi.org/10.1111/ans.15141.

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4

Cox, Michael R., Lyn Cook, Jennifer Dobson, Paul Lambrakis, Shanthan Ganesh, and Patrick Cregan. "Acute Surgical Unit: a new model of care." ANZ Journal of Surgery 80, no. 6 (June 1, 2010): 419–24. http://dx.doi.org/10.1111/j.1445-2197.2010.05331.x.

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5

Blucher, Kristopher M., Samuel E. Dal Pra, James Hogan, and Arkadiusz Peter Wysocki. "Ward safety checklist in the acute surgical unit." ANZ Journal of Surgery 84, no. 10 (December 16, 2013): 745–47. http://dx.doi.org/10.1111/ans.12496.

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6

Bazzi, Zacharia T., Ned Kinnear, Ciara S. Bazzi, Derek Hennessey, Maciej Henneberg, and Greg Otto. "Impact of an acute surgical unit on outcomes in acute cholecystitis." ANZ Journal of Surgery 88, no. 12 (September 11, 2018): E835—E839. http://dx.doi.org/10.1111/ans.14802.

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7

Suhardja, TS, L. Bae, EZ Seah, P. Cashin, and DG Croagh. "Acute surgical unit safely reduces unnecessary after-hours cholecystectomy." Annals of The Royal College of Surgeons of England 97, no. 8 (November 1, 2015): 568–73. http://dx.doi.org/10.1308/rcsann.2015.0035.

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Introduction The acute surgical model has been trialled in several institutions with mixed results. The aim of this study was to determine whether the acute surgical model provides better outcomes for patients with acute biliary presentation, compared with the traditional emergency surgery model of care. Methods A retrospective review was carried out of patients who were admitted for management of acute biliary presentation, before and after the establishment of an acute surgical unit (ASU). Outcomes measured were time to operation, operating time, after-hours operation (6pm – 8am), length of stay and surgical complications. Results A total of 342 patients presented with acute biliary symptoms and were managed operatively. The median time to operation was significantly reduced in the ASU group (32.4 vs 25.4 hours, p=0.047), as were the proportion of operations performed after hours (19.5% vs 2.5%, p<0.001) and the median length of stay (4 vs 3 days, p<0.001). The median operating time, rate of conversion to open cholecystectomy and wound infection rates remained similar. Conclusions Implementation of an ASU can lead to objective differences in outcomes for patients who present with acute cholecystitis. In our study, the ASU significantly reduced time to operation, the number of operations performed after hours and length of stay.

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8

Bown, Matthew J., M. G. A. Norwood, I. M. Loftus, P. Spiers, and R. D. Sayers. "The Surgical Acute Care Unit (SACU): effects on surgical workload and mortality." ANZ Journal of Surgery 74, no. 10 (October 2004): 881–84. http://dx.doi.org/10.1111/j.1445-1433.2004.03194.x.

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9

Karahalios, Amalia, and Steven T. F. Chan. "Re: Ward safety checklist in the acute surgical unit." ANZ Journal of Surgery 85, no. 4 (April 2015): 295. http://dx.doi.org/10.1111/ans.12994.

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10

Wang, Edward, Ravish Jootun, and Amanda Foster. "Management of acute appendicitis in an acute surgical unit: a cost analysis." ANZ Journal of Surgery 88, no. 12 (July 11, 2018): 1284–88. http://dx.doi.org/10.1111/ans.14727.

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11

Rooney, Siobhan, Ronan Waldron, Karl Sweeney, and Mark Regan. "AB196. 179. Acute surgical assessment unit—the evolving pathway for general surgical patients." Mesentery and Peritoneum 3 (February 2019): AB196. http://dx.doi.org/10.21037/map.2019.ab196.

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12

Lopes, Ana Martins, Diana Silva, Gabriela Sousa, Joana Silva, Alice Santos, and Fernando José Abelha. "Postoperative Haematocrit and Outcome in Critically Ill Surgical Patients." Acta Médica Portuguesa 30, no. 7-8 (August 31, 2017): 555. http://dx.doi.org/10.20344/amp.7930.

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Introduction: Haematocrit has been studied as an outcome predictor. The aim of this study was to evaluate the correlation between low haematocrit at surgical intensive care unit admission and high disease scoring system score and early outcomes.Material and Methods: This retrospective study included 4398 patients admitted to the surgical intensive care unit between January 2006 and July 2013. Acute physiology and chronic health evaluation and simplified acute physiology score II values were calculated and all variables entered as parameters were evaluated independently. Patients were classified as haematocrit if they had a haematocrit < 30% at surgical intensive care unit admission. The correlation between admission haematocrit and outcome was evaluated by univariate analysis and linear regression.Results: A total of 1126 (25.6%) patients had haematocrit. These patients had higher rates of major cardiac events (4% vs 1.9%, p < 0.001), acute renal failure (11.5% vs 4.7%, p < 0.001), and mortality during surgical intensive care unit stay (3% vs 0.8%, p < 0.001) and hospital stay (12% vs 5.9%, p < 0.001).Discussion: A haematocrit level < 30% at surgical intensive care unit admission was frequent and appears to be a predictor for poorer outcome in critical surgical patients.Conclusion: Patients with haematocrit had longer surgical intensive care unit and hospital stay lengths, more postoperative complications, and higher surgical intensive care unit and hospital mortality rates.

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13

Williams, R. J. Li, R. Hittinger, and G. Glazer. "Resource Implications of Head Injuries on an Acute Surgical Unit." Journal of the Royal Society of Medicine 87, no. 2 (February 1994): 83–86. http://dx.doi.org/10.1177/014107689408700209.

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Head injuries are expensive and demanding in terms of resources. In the UK, most are cared for outside neurosurgical centres. In the absence of specialist rehabilitation services, patients with on-going disability add to those admitted for observation and treatment on acute surgical wards. We audited the workload pattern and financial implications related to head injuries on a general surgical unit in a central London teaching hospital. Data collected prospectively at the time of admission and derived from departmental computerized information systems included clinical outcome, hospital stay and its relationship to severity of injury and other factors. Ward, departmental (accident and emergency (A & E), intensive therapy unit (ITU), radiology, and theatre) and neurosurgical referral costs were derived. Long-term social and rehabilitation costs were not calculated. Over a 6 month period 899 patients with head injuries were treated in the A & E department, of whom 156 were admitted. Of the admitted patients 68% were classified as minor; 22% as moderate; and 10% as severe head injuries. Fifty-one per cent of adult admissions were intoxicated by alcohol. Prolonged hospital stay was related to age, severity of head injury, mechanism of injury, associated injuries and preexisting neuropsychiatric conditions (including alcoholism). Six patients died. The direct cost of these head injuries patients was estimated at £173 500, during which time they occupied 7.6% of our unit's adult inpatient capacity. Twenty-four hour observation of 76 patients with minor head injuries contributed £9700 (5.6%) to this figure. Associated extracranial injuries cost a further £46 500. Head injuries are an important component of an acute unit's costs, particularly when the unit serves an inner city population where alcohol-related and neuropsychiatric problems are prevalent. In view of the financial implications involved, all hospitals whether directly managed or trusts will have to analyse their position in relation to local needs and available facilities.

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14

Hsee, Li, Marcelo Devaud, Lisa Middelberg, Wayne Jones, and Ian Civil. "Acute Surgical Unit at Auckland City Hospital: a descriptive analysis." ANZ Journal of Surgery 82, no. 9 (August 9, 2012): 588–91. http://dx.doi.org/10.1111/j.1445-2197.2012.06141.x.

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15

Pritchard, Natasha, Ryan Newbold, Kerian Robinson, and Wei Ming Ooi. "Effect of the acute general surgical unit: a regional perspective." ANZ Journal of Surgery 87, no. 7-8 (December 17, 2015): 595–99. http://dx.doi.org/10.1111/ans.13403.

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16

Sharma, G., R. Gupta, S. Rana, M. Kang, V. Sharma, and A. Kulkarni. "Referral pattern in acute pancreatitis to surgical unit and outcome." HPB 20 (September 2018): S515—S516. http://dx.doi.org/10.1016/j.hpb.2018.06.1898.

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17

Smith, P. D. Coleridge, M. M. Thompson, and K. A. Dookeran. "Audit of general practitioner referrals to an acute surgical unit." British Journal of Surgery 79, no. 10 (October 1992): 1111. http://dx.doi.org/10.1002/bjs.1800791043.

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18

Dookeran, K. A., M. M. Thompson, D. M. Lloyd, and N. W. Everson. "Audit of general practitioner referrals to an acute surgical unit." British Journal of Surgery 79, no. 5 (May 1992): 430–31. http://dx.doi.org/10.1002/bjs.1800790519.

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19

Hinkle, Janice L. "Development of an Acute Stroke Unit." Journal of Neuroscience Nursing 24, no. 2 (April 1992): 113–16. http://dx.doi.org/10.1097/01376517-199204000-00012.

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20

Zochodne, Douglas. "Myopathies in the Intensive Care Unit." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 25, S1 (February 1998): S40—S42. http://dx.doi.org/10.1017/s0317167100034727.

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AbstractMyopathies that occur in the intensive care unit can be divided into preexisting myopathies or newly acquired myopathies that develop in the intensive care unit. Myotonic dystrophy is an example of a preexisting myopathy that may render patients susceptible to acute respiratory failure following surgical procedures and anaesthesia. A group of myopathies that develop within the intensive care unit have been labelled acute necrotizing myopathy of intensive care, thick filament myopathy and acute steroid myopathy. Corticosteroids and nondepolarizing muscle blocking agents may play a role in their development.

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21

Lissauer, Matthew E., Jose J. Diaz, Mayur Narayan, Paulesh K. Shah, and Nader N. Hanna. "Surgical Intensive Care Unit Admission Variables Predict Subsequent Readmission." American Surgeon 79, no. 6 (June 2013): 583–88. http://dx.doi.org/10.1177/000313481307900618.

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Intensive care unit (ICU) readmissions are associated with increased resource use. Defining predictors may improve resource use. Surgical ICU patients requiring readmission will have different characteristics than those who do not. We conducted a retrospective cohort study of a prospectively maintained database. The Acute Physiology and Chronic Health Evaluation (APACHE) IV quality database identified patients admitted January 1 through December 31, 2011. Patients were divided into groups: NREA = patients admitted to the ICU, discharged, and not readmitted versus REA = patients admitted to the ICU, discharged, and readmitted. Comparisons were made at index admission, not readmission. Categorical variables were compared by Fisher's exact testing and continuous variables by t test. Multivariate logistic regression identified independent predictors of readmission. There were 765 admissions. Seventy-seven patients required readmission 94 times (12.8% rate). Sixty-two patients died on initial ICU admission. Admission severity of illness was significantly higher (APACHE III score: 69.54 ± 21.11 vs 54.88 ± 23.48) in the REA group. Discharge acute physiology scores were equal between groups (47.0 ± 39.2 vs 44.2 ± 34.0, P = nonsignificant). In multivariate analysis, REA patients were more likely admitted to emergency surgery (odds ratio, 1.9; 95% confidence interval, 1.01 ± 3.5) more likely to have a history of immunosuppression (2.7, 1.4 ± 5.3) or higher Acute Physiology Score (1.02; 1.0 ± 1.03) than NREA. Patients who require ICU readmission have a different admission profile than those who do not “bounce back.” Understanding these differences may allow for quality improvement projects such as instituting different discharge criteria for different patient populations.

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22

Shilton, Hamish, Amin Tanveer, Benjamin Ruimin Poh, Daniel Croagh, Neil Jayasuriya, and David Chan. "Is the acute surgical unit model feasible for Australian regional centres?" ANZ Journal of Surgery 86, no. 11 (August 31, 2016): 889–93. http://dx.doi.org/10.1111/ans.13724.

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23

Jiang, Lisa, Heather Douglas, Miguel Laxa, Leena Mathew, Sharon Sarmiento, Kimberly Vanderhorst, and Elizabeth Vogler. "Respond, Intervene and Escalate: Acute Stroke Events in the Post Anesthesia Care Unit." Journal of PeriAnesthesia Nursing 34, no. 4 (August 2019): e15. http://dx.doi.org/10.1016/j.jopan.2019.05.043.

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24

Han, Angela, Laurie J. Conway, Christine Moore, Liz McCreight, Kelsey Ragan, Jannice So, Emily Borgundvaag, Mike Larocque, Brenda L. Coleman, and Allison McGeer. "Unit-Specific Rates of Hand Hygiene Opportunities in an Acute-Care Hospital." Infection Control & Hospital Epidemiology 38, no. 4 (December 28, 2016): 411–16. http://dx.doi.org/10.1017/ice.2016.308.

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OBJECTIVETo explore the frequency of hand hygiene opportunities (HHOs) in multiple units of an acute-care hospital.DESIGNProspective observational study.SETTINGThe adult intensive care unit (ICU), medical and surgical step-down units, medical and surgical units, and the postpartum mother–baby unit (MBU) of an academic acute-care hospital during May–August 2013, May–July 2014, and June–August 2015.PARTICIPANTSHealthcare workers (HCWs).METHODSHHOs were recorded using direct observation in 1-hour intervals following Public Health Ontario guidelines. The frequency and distribution of HHOs per patient hour were determined for each unit according to time of day, indication, and profession.RESULTSIn total, 3,422 HHOs were identified during 586 hours of observation. The mean numbers of HHOs per patient hour in the ICU were similar to those in the medical and surgical step-down units during the day and night, which were higher than the rates observed in medical and surgical units and the MBU. The rate of HHOs during the night significantly decreased compared with day (P<.0001). HHOs before an aseptic procedure comprised 13% of HHOs in the ICU compared with 4%–9% in other units. Nurses contributed >92% of HHOs on medical and surgical units, compared to 67% of HHOs on the MBU.CONCLUSIONSAssessment of hand hygiene compliance using product utilization data requires knowledge of the appropriate opportunities for hand hygiene. We have provided a detailed characterization of these estimates across a wide range of inpatient settings as well as an examination of temporal variations in HHOs.Infect Control Hosp Epidemiol2017;38:411–416

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25

Payne, Ann, and Julius Essem. "Management of patients' physical health in an acute psychiatric unit." Irish Journal of Psychological Medicine 25, no. 4 (December 2008): 127–30. http://dx.doi.org/10.1017/s079096670001123x.

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AbstractObjective: The aim of this study was to help clarify the range of acute medical problems experienced by patients on an acute psychiatric unit during a period of 28 days and nights, as encountered by psychiatric trainees, and to document any difficulties experienced by the trainee during these patient contacts.Method: This survey was carried out prospectively over 28 days and nights in an acute psychiatric ward attached to a teaching University Hospital. Following contact with an individual patient, the trainee recorded diagnosis, intervention and any difficulties encountered.Results: Thirty-three patient contacts were recorded (n = 33). Trainees faced a range of primary care problems 22/33 (67%), but moreover, three patients demonstrated more serious and potentially life threatening problems, leading to 11/33 (33%) patient contacts requiring urgent interventions.Conclusions: While the debate continues as to who is best placed to provide medical healthcare for psychiatric patients, this study provides evidence that psychiatry trainees are required to draw on their previous medical and surgical experience on an almost daily basis. As psychiatrists we should consider our options on how best to manage medical problems on the acute psychiatric unit and consequently ensure confident liaison with our medical and surgical colleagues.

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26

McLaren, Emma, and Charles Maxwell-Armstrong. "Noise Pollution on an Acute Surgical Ward." Annals of The Royal College of Surgeons of England 90, no. 2 (March 2008): 136–39. http://dx.doi.org/10.1308/003588408x261582.

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INTRODUCTION This study was undertaken to measure and analyse noise levels over a 24-h period on five general surgical wards. PATIENTS AND METHODS Noise levels were measured on three wards with four bays of six beds each (wards A, B and C), one ward of side-rooms only (ward D) and a surgical high dependency unit (ward E) of eight beds. Noise levels were measured for 15 min at 4-hourly intervals over a period of 24 h midweek. The maximum sound pressure level, baseline sound pressure level and the equivalent continuous level (LEq) were recorded. Peak levels and LEq were compared with World Health Organization (WHO) guidelines for community noise. Control measurements were taken elsewhere in the hospital and at a variety of public places for comparison. RESULTS The highest peak noise level recorded was 95.6 dB on ward E, a level comparable to a heavy truck. This exceeded all control peak readings except that recorded at the bus stop. Peak readings frequently exceeded 80 dB during the day on all wards. Each ward had at least one measurement which exceeded the peak sound level of 82.5 dB recorded in the supermarket. The highest peak measurements on wards A, B, C and E also exceeded peak readings at the hospital main entrance (83.4 dB) and coffee shop (83.4 dB). Ward E had the highest mean peak reading during the day and at night – 83.45 dB and 81.0 dB, respectively. Ward D, the ward of side-rooms, had the lowest day-time mean LEq (55.9 dB). Analysis of the LEq results showed that readings on ward E were significantly higher than readings on wards A, B and C as a group (P = 0.001). LEq readings on ward E were also significantly higher than readings on ward D (P < 0.001). Day and night levels differ significantly, but least so on the high dependency unit. CONCLUSIONS The WHO guidelines state that noise levels on wards should not exceed 30 dB LEq (day and night) and that peak noise levels at night should not exceed 40 dB. Our results exceed these guidelines at all times. It is likely that these findings will translate to other hospitals. Urgent measures are needed to rectify this.

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27

Wassef, Mona, Ahmed Mukhtar, Ahmed Nabil, Moushira Ezzelarab, and Doaa Ghaith. "Care Bundle Approach to Reduce Surgical Site Infections in Acute Surgical Intensive Care Unit, Cairo, Egypt." Infection and Drug Resistance Volume 13 (January 2020): 229–36. http://dx.doi.org/10.2147/idr.s236814.

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28

Pragacz, Krzysztof, Marcin Barczyński, Rafał Kuchciński, Andrzej Zieliński, and Ireneusz Nawrot. "Utility of the laparoscopic approach to surgical treatment of acute appendicitis in a single surgical unit." Videosurgery and Other Miniinvasive Techniques 2 (2014): 234–38. http://dx.doi.org/10.5114/wiitm.2014.42511.

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29

Krall, Eva, Jacqueline Close, Joseph Parker, Maria Sudak, Susan Lampert, and Kim Colonnelli. "Innovation Pilot Study: Acute Care for Elderly (ACE) Unit—Promoting Patient-Centric Care." HERD: Health Environments Research & Design Journal 5, no. 3 (April 2012): 90–98. http://dx.doi.org/10.1177/193758671200500309.

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Purpose: Older patients, defined as age 65 years or older, comprise more than 40% of admissions to the acute care environment. These patients' needs are different; cognitive impairment, chronic health issues, caregiver burden, and maintenance of functional level present challenges to healthcare organizations when caring for this population on a general medical-surgical unit. Background: A pilot project, the creation of a six-bed Acute Care for Elderly (ACE) unit situated within a 33-bed medical-surgical unit, was established to meet the unique needs of this older patient population. Conclusions: Outcomes including falls, pressure ulcers, functional level (the latter as measured by the KATZ), and length of stay were examined and demonstrated marked improvement compared to similar patients outside the ACE unit. Older patients need individualized care planning by staff competent in elder care and a specialty unit to address their specific needs

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30

Jaboury, Imad Afram. "Re: Is the acute surgical unit model feasible for Australian regional centres?" ANZ Journal of Surgery 87, no. 4 (April 2017): 314–15. http://dx.doi.org/10.1111/ans.13902.

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31

Ryan, Thomas, Preet Gosal, Alexa Seal, Joe McGirr, and Nicholas Williams. "Association of waist circumference with outcomes in an acute general surgical unit." ANZ Journal of Surgery 87, no. 6 (April 24, 2017): 453–56. http://dx.doi.org/10.1111/ans.13962.

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32

Kinnear, Ned, Philip Britten-Jones, Derek Hennessey, Diwei Lin, Darren Lituri, Subhita Prasannan, and Greg Otto. "Impact of an acute surgical unit on patient outcomes in South Australia." ANZ Journal of Surgery 87, no. 10 (July 6, 2017): 825–29. http://dx.doi.org/10.1111/ans.14100.

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33

Styan, Lauren, Skyle Murphy, Aisling Fleury, Brian McGowan, and Martin Wullschleger. "Establishing a successful perioperative geriatric service in an Australian acute surgical unit." ANZ Journal of Surgery 88, no. 6 (February 18, 2018): 607–11. http://dx.doi.org/10.1111/ans.14411.

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34

Barry, M. C., Y. Gul, M. G. Davies, D. Long, M. F. Shine, and F. Lennon. "Changing trends in acute peptic ulcer surgery in a district surgical unit." Irish Journal of Medical Science 165, no. 2 (April 1996): 109–12. http://dx.doi.org/10.1007/bf02943795.

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35

Beardsley, C. J., T. Sandhu, S. Gubicak, S. V. Srikanth, K. P. Galketiya, and F. Piscioneri. "A model-based evaluation of the Canberra Hospital Acute Care Surgical Unit." Surgery Today 44, no. 5 (November 1, 2013): 884–87. http://dx.doi.org/10.1007/s00595-013-0775-2.

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36

Hsu, Chih-Ho, Chen-Lun Chiu, Yi-Ting Lin, Ann-Yu Yu, Yen-Te Kang, Michael Cherng, Yi-Hui Chen, et al. "Triage admission protocol with a centralized quarantine unit for patients after acute care surgery during the COVID-19 pandemic: A tertiary center experience in Taiwan." PLOS ONE 17, no. 3 (March 9, 2022): e0263688. http://dx.doi.org/10.1371/journal.pone.0263688.

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Background During the COVID-19 surge in Taiwan, the Far East Memorial Hospital established a system including a centralized quarantine unit and triage admission protocol to facilitate acute care surgical inpatient services, prevent nosocomial COVID-19 infection and maintain the efficiency and quality of health care service during the pandemics. Materials and methods This retrospective cohort study included patients undergoing acute care surgery. The triage admission protocol was based on rapid antigen tests, Liat® PCR and RT-PCT tests. Type of surgical procedure, patient characteristics, and efficacy indices of the centralized quarantine unit and emergency department (ED) were collected and analyzed before (Phase I: May 11 to July 2, 2021) and after (Phase II: July 3 to July 31, 2021) the system started. Results A total of 287 patients (105 in Phase I and 182 in Phase II) were enrolled. Nosocomial COVID-19 infection occur in 27 patients in phase I but zero in phase II. More patients received traumatological, orthopedic, and neurologic surgeries in phase II than in phase I. The patients’ surgical risk classification, median total hospital stay, intensive care unit (ICU) stay, intraoperative blood loss, operation time, and the number of patients requiring postoperative ICU care were similar in both groups. The duration of ED stay and waiting time for acute care surgery were longer in Phase II (397 vs. 532 minutes, p < 0.0001). The duration of ED stay was positively correlated with the number of surgical patients visiting the ED (median = 66 patients, Spearman’s ρ = 0.207) and the occupancy ratio in the centralized quarantine unit on that day (median = 90.63%, Spearman’s ρ = 0.191). Conclusions The triage admission protocol provided resilient quarantine needs and sustainable acute care surgical services during the COVID-19 pandemic. The efficiency was related to the number of medical staff dedicated to the centralized quarantine unit and number of surgical patients visited in ED.

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Pepingco, Lester, Guy D. Eslick, and Michael R. Cox. "The acute surgical unit as a novel model of care for patients presenting with acute cholecystitis." Medical Journal of Australia 196, no. 8 (May 2012): 509–10. http://dx.doi.org/10.5694/mja11.11361.

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Romanauski, Timothy R., Erin E. Martin, Juraj Sprung, David P. Martin, Darrell R. Schroeder, and Toby N. Weingarten. "Delirium in Postoperative Patients Admitted to the Intensive Care Unit." American Surgeon 84, no. 6 (June 2018): 875–80. http://dx.doi.org/10.1177/000313481808400635.

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Postoperative delirium (POD) is common among surgical patients admitted to the intensive care unit (ICU) and is associated with increased resource utilization, morbidity, and death. Our primary aim was to compare rates of POD using administrative International Classification of Diseases, Ninth Revision, records and automated interrogation of electronic health records from Confusion Assessment Method for the ICU (CAM-ICU) screening. The secondary aim was to assess POD risk associated with patient and perioperative characteristics. Electronic health records of surgical patients admitted to the ICU during 2011 through 2014 were abstracted for POD assessment by CAM-ICU and by administrative codes, Charlson comorbidity index, surgical characteristics, and Acute Physiology, Age, Chronic Health Evaluation III scores. Of 6338 patients, CAM-ICU identified 606 (9.6%) and administrative records identified 55 (0.9%) POD cases, with agreement on 50 cases. In multivariable logistic regression based on POD identified with CAM-ICU, preexisting dementia had the strongest association with POD (odds ratio [95% confidence interval], 6.47 [3.68–11.37]; P < 0.001). Other associations found were older age, congestive heart failure, chronic pulmonary disease, increased surgical duration, emergency cases, blood transfusions, postoperative ventilation, and higher Acute Physiology, Age, Chronic Health Evaluation III scores (all P ≤ 0.01). POD cases had lengthier ICU and hospital stays and a higher mortality rate (all P < 0.001). CAM-ICU scores identified higher rates of POD than a search for POD based on administrative codes. Preoperative presence of dementia and major comorbidities were associated with POD. Delirium in surgical patients is associated with worse outcomes.

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BHOPAL, FAISAL G., FARYAL AZHAR, SHAHID MAHMOOD, and Muhammed Iqbal. "ACUTE PANCREATITIS." Professional Medical Journal 18, no. 03 (September 10, 2011): 366–72. http://dx.doi.org/10.29309/tpmj/2011.18.03.2314.

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Acute pancreatitis represents a spectrum of disease ranging from a mild, self-limited course to a rapidly progressive, severe illness. The mortality rate of severe acute pancreatitis exceeds 20%, and some patients diagnosed as mild to moderate acute pancreatitis at the onset of the disease may progress to a severe, life-threatening illness within 2-3 days1. Setting: A study was conducted in RGH (Now BBH). Period: January, 1997 to January, 2001. All patients with abdominal pain and having a serum amylase level of five times the normal range, were included in the study. 72 patients were admitted. 29 (40.2%) were males and 42 (59.7%) were females. Male to female ratio was 2:3. The age of the patients ranged from 7 years to 85 years (average age 40 years). Disease severity was assessed according to Ranson’s criteria. They were managed in a general surgical ward or intensive care unit when indicated. Development of complications and their management done were recorded. Patients stayed in the hospital from 1-21 days with an average period of 8.59 days. 32 (44.44%) recovered uneventfully without any complication while 40 (55.55%) patients developed either local or systemic complications. Overall 10 (13.88%) patients died early in the course of disease i.e. within one week. All of them were above 55 years of age, 6 of them were females and 4 of them were males, mortality ratio for female to male was 3:2. Purpose of study: (1) To study the morbidity and mortality in patients of acute pancreatitis. (2) To evaluate the management of acute pancreatitis in a general surgical unit. Conclusions: Management of mild acute pancreatitis is simple, it needs only supportive treatment. However, the management of severe acute pancreatitis is complex. Mortality is high and the treatment requires individualized approach regarding timing of surgery and choice of technique.

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Bukhari, Hassan Adnan, and Anand Kumar. "Early Surgical Intervention Improves Survival in Acute Intestinal Ischemia in the Intensive Care Unit." BioMed Research International 2021 (May 17, 2021): 1–6. http://dx.doi.org/10.1155/2021/6672591.

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The study is aimed at assessing whether the early surgical intervention improves survival in acute mesenteric ischemia with septic shock. A retrospective study design was applied to review the charts of patients admitted to the intensive care unit. The data were collected through a review of the full patient chart including physician and nursing notes, pathology reports, intraoperative findings, CT findings, and endoscopy. The diagnosis of AMI for each patient was determined through clinical presentation/endoscopic visualization/laboratory results/radiographic imaging, surgical exam (tissue or visual) and/or autopsy. Death and survival were evaluated between short and long-time-interval for septic shock groups using the chi-square test followed by calculating the P value. Total survival among the surgery group was 60 patients (95.24%) compared to 3 (4.76%) survival among patients who did not have surgery. The time from the onset of a shock to the time of surgical incision was calculated. The mean time to surgery was 17.7 hours. Total 65 patients (29.52%) had surgery between 4 and 12 hours from the onset of hypotension. Survivals among this group of patients were 41.7% ( n = 25 ). The survival difference was statistically significant than died patients with respect to the time of surgical intervention ( P = < 0.001 ). Early removal of ischemic bowel in patients with AII-related surgery has improved survival.

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Khotaniwong, Buppha, and Dr Bumpenchit Sangchat. "Development of Acute Pain Assessment Tool in Surgical Intensive Care Unit for Nurses." Khon Kaen University Journal (Graduate Studies) 07, no. 1 (July 1, 2007): 83–93. http://dx.doi.org/10.5481/kkujgs.2007.07.8.

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42

Anami, EHT, T. Matsuo, CMC Grion, TF Perazolo, and LTQ Cardoso. "Evaluation of acute renal failure in surgical patients in the intensive care unit." Critical Care 11, Suppl 3 (2007): P57. http://dx.doi.org/10.1186/cc5844.

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TANAKA, KEIJI, TAKANO TERUO, KENJI SASAKI, HIDETOSHI UTSUNOMIYA, SHIGEO TANAKA, TASUKU SHOJI, and HIROKAZU HAYAKAWA. "Medical vs surgical treatment of acute aortic dissection in an intensive care unit." Japanese Circulation Journal 55, no. 8 (1991): 815–20. http://dx.doi.org/10.1253/jcj.55.815.

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FASSBENDER, KLAUS, HANS PARGGER, WOLFGANG MÜLLER, and WERNER ZIMMERLI. "Interleukin-6 and acute-phase protein concentrations in surgical intensive care unit patients." Critical Care Medicine 21, no. 8 (August 1993): 1175–80. http://dx.doi.org/10.1097/00003246-199308000-00017.

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BORLASE, BRADLEY C., JOHN K. BAXTER, PARDON R. KENNEY, R. ARMOUR FORSE, PETER N. BENOTTI, and GEORGE L. BLACKBURN. "Elective Intrahospital Admissions Versus Acute Interhospital Transfers to a Surgical Intensive Care Unit." Journal of Trauma: Injury, Infection, and Critical Care 31, no. 7 (July 1991): 915–19. http://dx.doi.org/10.1097/00005373-199107000-00006.

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46

Allaway, Matthew G. R., Guy D. Eslick, Grace T. Y. Kwok, and Michael R. Cox. "The Established Acute Surgical Unit: A reduction in nighttime appendicectomy without increased morbidity." International Journal of Surgery 43 (July 2017): 81–85. http://dx.doi.org/10.1016/j.ijsu.2017.05.045.

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47

Hsee, Li, Marcelo Devaud, and Ian Civil. "Key Performance Indicators in an Acute Surgical Unit: Have We Made an Impact?" World Journal of Surgery 36, no. 10 (June 7, 2012): 2335–40. http://dx.doi.org/10.1007/s00268-012-1670-5.

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Guy, Stephen, and Carl Lisec. "Emergency laparotomy outcomes before and after the introduction of an acute surgical unit." International Journal of Surgery Open 10 (2018): 61–65. http://dx.doi.org/10.1016/j.ijso.2017.12.001.

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Gibbons, Genevieve, Chuan Jin Tan, David C. C. Bartolo, Rhys Filgate, Greg Makin, Nigel Barwood, and Marina Wallace. "Emergency left colonic resections on an acute surgical unit: does subspecialization improve outcomes?" ANZ Journal of Surgery 85, no. 10 (May 21, 2015): 739–43. http://dx.doi.org/10.1111/ans.13160.

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Singh, Shridevi, Jody C. DiGiacomo, L. D. George Angus, Sara Cardozo-Stolberg, Noam Gerber, and Swapna Munnangi. "Does a Surgical Post-Acute Unit Help Elders With Rib Fractures? Definitely Maybe!" Journal of Trauma Nursing 27, no. 2 (2020): 71–76. http://dx.doi.org/10.1097/jtn.0000000000000489.

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