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23 septembre 2019
- doi: 10.4414/smw.2019.20117
- issn: 0036-7672
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info:eu-repo/semantics/altIdentifier/doi/10.4414/smw.2019.20117
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info:eu-repo/semantics/altIdentifier/pmid/31568553
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info:eu-repo/semantics/altIdentifier/eissn/1424-3997
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info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_3B996417FE8D4
info:eu-repo/semantics/openAccess , CC BY-NC-ND 4.0 , https://creativecommons.org/licenses/by-nc-nd/4.0/
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Diseases--Surgery Surgery, PrimitiveCiter ce document
G. Paratte et al., « Impact of staffing a surgical intermediate care unit with a critical care specialist. », Serveur académique Lausannois, ID : 10.4414/smw.2019.20117
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Résumé
To assess the impact of reorganising an 11-bed surgical intermediate care unit (IMCU) from an open to a semi-closed system in a Swiss University Hospital by adding a critical care specialist (CCS). This was a cohort study including adult IMCU patients enrolled in an Enhanced Recovery After Surgery protocol in the Department of Visceral Surgery, Lausanne University Hospital, from 1 February 2014 to 31 January 2016. Medical supervision by a CCS was implemented on 1 February 2015. Introduction of a CCS in a surgical IMCU significantly reduced intensive care unit length of stay (p = 0.005) and potentially preventable operation (p = 0.04) for patients undergoing oesophageal surgery. A CCS in IMCU also proved to significantly reduce readmission in IMCU for hepatic surgery patients (p = 0.04). For other sub-specialties (colorectal, pancreatic and gastric bypass surgery) no significant difference could be found. Reorganisation of a surgical IMCU from an open to a semi-closed system by implementing supervision by a CCS decreased length of stay and complications for the most fragile surgical patients (oesophageal and hepatic patients) after 12 months of implementation.