Perioperative Risk Assessment, Postoperative Intensive Care Unit Admission
Conditions
Brief summary
This prospective observational pilot study will evaluate how accurately anesthesiologists can predict, before a procedure, whether an adult patient will require admission to an intensive care unit (İCU) after surgery or an endoscopic procedure. Before each procedure, the anesthesiologist will record whether postoperative intensive care unit (İCU) care is expected and the clinical factors influencing this assessment. No changes will be made to the patient's usual medical care. After the procedure, the researchers will record whether the patient was admitted to the İCU and whether the admission was planned or unplanned. Additional information, including İCU and hospital length of stay, need for organ support, and in-hospital mortality, will also be collected when applicable. The pilot study will also assess whether the planned data collection process is practical and whether the required study information can be collected completely before conducting the main prospective study.
Interventions
Before the index procedure, the anesthesiologist will record whether postoperative intensive care unit admission is anticipated based on routine preoperative clinical assessment. This assessment is observational and will not alter routine patient care.
Sponsors
Study design
Eligibility
Inclusion criteria
* Age 18 years or older. * Undergoing an eligible surgical or endoscopic procedure on a predefined study day. * The american society of anesthesiologists (ASA) Physical Status of I-II and undergoing a major surgical or endoscopic procedure, or ASA Physical Status of III-V and undergoing an eligible surgical or endoscopic procedure. * Preoperative anesthesiology assessment completed before the procedure.
Exclusion criteria
* Age younger than 18 years. * ASA Physical Status of I-II and undergoing a minor or non-major procedure. * Undergoing cardiac surgery. * Already admitted to an intensive care unit before the index procedure. * The planned surgical or endoscopic procedure is not ultimately performed. * The required preoperative assessment cannot be completed before the procedure.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Accuracy of Preoperative Prediction of Postoperative Intensive Care Unit Admission | Within 24 hours after the index surgical or endoscopic procedure | Overall prediction accuracy will be calculated as the proportion of evaluable patients for whom the anesthesiologist's preoperative prediction of postoperative intensive care unit (İCU) need agrees with actual İCU admission status within 24 hours after the index procedure. Patients with mandatory postoperative İCU admission according to institutional protocol will not be included in this primary analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Unanticipated Postoperative Intensive Care Unit Admission | Within 24 hours after the index surgical or endoscopic procedure | The proportion of evaluable patients who are admitted to the intensive care unit (İCU) within 24 hours after the index procedure despite postoperative İCU care not being anticipated during the preoperative anesthesiology assessment. |
Countries
Turkey (Türkiye)