1887
Volume 2025, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

An unplanned intensive care admission (UIA) after elective surgery is a clinical indicator of patient safety and outcomes. Furthermore, it reflects both surgery- and anesthesia-related complications. The overall rate of UIA ranges from 0.28% to 2.2%. UIA is linked with higher rates ofmorbidity and mortality in surgical patients. Thus, understanding the factors leading to UIAs could improve the quality of patient care. In this study, we aimed to determine the rate and reasons for UIA following elective surgeries in public facilities in Qatar.

UIA was defined as an admission to the intensive care unit (ICU) within 72 hours of anesthesia that was not anticipated during the pre-anesthesia assessment phase. A multicenter audit was conducted from January 1, 2021, to December 31, 2021, across five public hospitals in Qatar. UIA was identified from the electronic preoperative and postoperative anesthetic assessment notes and intraoperative notes.

Among the 2,087 ICU admissions, 42 (2.0%) were UIAs. Among the 42 patients, 57.1% were males, and the mean age was 41.83 ± 12.95 years. Most patients (64.3%) were classified as American Society of Anesthesiologists status II. The mean length of ICU stay was 2.60 ± 2.45 days. Most of the UIAs were surgery-related (54.8%), followed by anesthesia-related (26.2%) and medical-related (16.6%).

The rate of UIA in our study was 2%, corresponding to the wide range of incidence reported in the literature. The causes of UIA are multiple; however, our study showed that the rate of anesthesia-related UIAs was 26.2%, which is less than in most previous studies.

© 2025 Ghafoor, Hammad, Khair, Ahmed, Karunakaran, Elgendy, et al., licensee HBKU Press.
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2025-06-11
2025-07-16
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References

  1. Singh V, Datta R, Sasidharan S, Tomar L, Babitha M. Prospective evaluation and analysis of postoperative admissions in the intensive care unit of a tertiary care hospital: an Indian update. J Transl Crit Care Med. 2019; 1:127–34. https://doi.org/10.4103/jtccm.jtccm_6_20
     [Google Scholar]
  2. de Nadal M, Pérez-Hoyos S, Montejo-González JC, Pearse R, Aldecoa C. European surgical outcomes study (EuSOS) in Spain. Intensive care admission and hospital mortality in the elderly after non-cardiac surgery. Med Intensiva. 2018; 42:463–72. https://doi.org/10.1016/j.medin.2018.01.009
     [Google Scholar]
  3. Bansal BK, Deval NS, Bedi V. Prospective analysis of post-operative admissions in the intensive care unit of a tertiary care hospital. Int J Med Res Prof. 2020; 6:103–7. https://doi.org/10.21276/ijmrp.2020.6.2.024
     [Google Scholar]
  4. Yetneberk T, Firde M, Tiruneh A, Fentie Y, Tariku M, Mihret G, et al.. Incidence of unplanned intensive care unit admission following surgery and associated factors in Amhara Regional State Hospitals. Sci Rep. 2022; 12:20121. https://doi.org/10.1038/s41598-022-24571-1
     [Google Scholar]
  5. Katori N, Yamakawa K, Yagi K, Kimura Y, Doi M, Uezono S. Characteristics and outcomes of unplanned intensive care unit admission after general anesthesia. BMC Anesthesiol. 2022; 22:191. https://doi.org/10.1186/s12871-022-01729-y
     [Google Scholar]
  6. Onwochei DN, Fabes J, Walker D, Kumar G, Moonesinghe SR. Critical care after major surgery: a systematic review of risk factors for unplanned admission. Anaesthesia. 2020; 75:(1)(Suppl. 1):e62–74. https://doi.org/10.1111/anae.14793
     [Google Scholar]
  7. Quinn TD, Gabriel RA, Dutton RP, Urman RD. Analysis of unplanned postoperative admissions to the intensive care unit. J Intensive Care Med. 2017; 32:436–43. https://doi.org/10.1177/0885066615622124
     [Google Scholar]
  8. Kim J, Kim YD, Lee DR, Kim KM, Lee WY, Lee S, et al.. Analysis of the characteristics of unplanned admission to the intensive care unit after general surgery. Anesth Pain Med. 2019; 14:230–5. https://doi.org/10.17085/apm.2019.14.2.230
     [Google Scholar]
  9. Kurowski I, Sims C. Unplanned anesthesia-related admissions to pediatric intensive care – a 6-year audit. Paediatr Anaesth. 2007; 17:575–80. https://doi.org/10.1111/j.1460-9592.2006.02154.x
     [Google Scholar]
  10. Gibson AR, Limb J, Bell G. Retrospective audit of unplanned admissions to pediatric high dependency and intensive care after surgery. Paediatr Anaesth. 2014; 24:372–6. https://doi.org/10.1111/pan.12343
     [Google Scholar]
  11. Lin YC, Chen YC, Yang CH, Su NY. Surgical Apgar score is strongly associated with postoperative ICU admission. Sci Rep. 2021; 11:115. https://doi.org/10.1038/s41598-020-80393-z
     [Google Scholar]
  12. Tsuboi K, Ninagawa J, Tsuboi N, Nakagawa S, Suzuki Y. Unplanned admission to pediatric intensive care after general anesthesia: a seven-year retrospective cohort study in a tertiary children’s hospital. Paediatr Anaesth. 2022; 32:56–61. https://doi.org/10.1111/pan.14313
     [Google Scholar]
  13. Meziane M, El Jaouhari SD, ElKoundi A, Bensghir M, Baba H, Ahtil R, et al.. Unplanned intensive care unit admission following elective surgical adverse events: incidence, patient characteristics, preventability, and outcome. Indian J Crit Care Med. 2017; 21:127–30. https://doi.org/10.4103/ijccm.IJCCM_428_16
     [Google Scholar]
  14. Habas E, Al Halabi AM, Saleem MS, Ghazouani H, Hommos AA, Borham AM, et al.. Redistribution of doctors and decentralization of clinics improved utilization of services, demand, and capacity of Hamad Medical Corporation’s Staff Clinic. Cureus. 2022; 14:e25883. https://doi.org/10.7759/cureus.25883
     [Google Scholar]
  15. Cao Q, Fan C, Li W, Bai S, Dong H, Meng H. Unplanned post-anesthesia care unit to ICU transfer following cerebral surgery: a retrospective study. Biol Res Nurs. 2023; 25:129–36. https://doi.org/10.1177/10998004221123288
     [Google Scholar]
  16. Morgan DJR, Ho KM, Armstrong J, Baker S. Incidence and risk factors for intensive care unit admission after bariatric surgery: a multicentre population-based cohort study. Br J Anaesth. 2015; 115:873–82. https://doi.org/10.1093/bja/aev364
     [Google Scholar]
  17. da Silva PSL, de Aguiar VE, Fonseca MCM. Risk factors and outcomes of unplanned PICU postoperative admissions: a nested case-control study. Pediatr Crit Care Med. 2013; 14:420–8. https://doi.org/10.1097/PCC.0b013e3182720fab
     [Google Scholar]
  18. Tillmann BW, Hallet J, Sutradhar R, Guttman MP, Coburn N, Chesney TR, et al.. Members of the recovery after surgical therapy for older adults research – cancer (RESTORE-C) group. The impact of unexpected intensive care unit admission after cancer surgery on long-term symptom burden among older adults: a population-based longitudinal analysis. Crit Care. 2023; 27:162. https://doi.org/10.1186/s13054-023-04415-8
     [Google Scholar]
  19. Penk JS, Loke YH, Waloff KR, Frank LH, Stockwell DC, Spaeder MC, et al.. Unplanned admissions to a pediatric cardiac critical care unit: a review of 2 years. Pediatr Crit Care Med. 2015; 16:155–60. https://doi.org/10.1097/PCC.0000000000000316
     [Google Scholar]
  20. Okafor UV. An audit of unplanned postoperative intensive care unit admissions in Enugu, Nigeria: causes and outcome. SAJCC. 2009; 25:16–9. https://www.journals.co.za/doi/pdf/10.10520/EJC64619
     [Google Scholar]
  21. Emerson P, Flabouris A, Thomas J, Fernando J, Senthuran S, Knowles S, et al.. Intensive care utilisation after elective surgery in Australia and New Zealand: a point prevalence study. Crit Care Resusc. 2024; 26:1–7. https://doi.org/10.1016/j.ccrj.2023.10.010
     [Google Scholar]
  22. Hantouly AT, AlBarazanji A, Al-Juboori M, Alebbini M, Toubasi AA, Mohammed A, et al.. Epidemiology of proximal femur fractures in the young population of Qatar. Eur J Orthop Surg Traumatol. 2024; 34:21–9. https://doi.org/10.1007/s00590-023-03664-1
     [Google Scholar]
  23. Bohini K, Yaganti CH, Thomas MP. India’s demographic dividend: the Millennials’ savings conundrum. Millenn Asia. 2022; 13:108–41. https://doi.org/10.1177/0976399620958262
     [Google Scholar]
  24. Uzman S, Yilmaz Y, Toptas M, Akkoc I, Gul YG, Daskaya H, et al.. A retrospective analysis of postoperative patients admitted to the intensive care unit. Hippokratia. 2016; 20:38–43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074395/
     [Google Scholar]
  25. Sukhonthamarn K, Grosso MJ, Sherman MB, Restrepo C, Parvizi J. Risk factors for unplanned admission to the intensive care unit after elective total joint arthroplasty. J Arthroplasty. 2020; 35:1937–40. https://doi.org/10.1016/j.arth.2020.03.003
     [Google Scholar]
  26. Phoowanakulchai S, Jirauraipong Y, Kongsayreepong S, Therasakvichya S, Nivatpumin P, Somnuke P. Rate and factors related to postoperative intensive care unit (ICU) utilization in elective gynecologic oncology patients. Thai J Anesthesiol. 2022; 48:99–112. https://he02.tci-thaijo.org/index.php/anesthai/article/view/257006
     [Google Scholar]
  27. Mitchell J, Clément de Clety S, Collard E, De Kock M, Detaille T, Houtekie L, et al.. Unplanned intensive care unit admission after general anaesthesia in children: a single centre retrospective analysis. Anaesth Crit Care Pain Med. 2016; 35:203–8. https://doi.org/10.1016/j.accpm.2015.10.005
     [Google Scholar]
  28. Hezkial M, Ward BM, Silbert B, Santamaria JD, Duffy M. Attendance at anaesthetic or perioperative medicine preadmission clinic and the relationship with unplanned ICU and HDU admission postoperatively. Perioper Care Oper Room Manag. 2023; 30:100301. https://doi.org/10.1016/j.pcorm.2022.100301
     [Google Scholar]
  29. Haller G, Myles PS, Langley M, Stoelwinder J, McNeil J. Assessment of an unplanned admission to the intensive care unit as a global safety indicator in surgical patients. Anaesth Intensive Care. 2008; 36:190–200. https://doi.org/10.1177/0310057X0803600209
     [Google Scholar]
/content/journals/10.5339/qmj.2025.35
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An analysis of unplanned postoperative admissions to the intensive care units at different hospitals across Hamad Medical Corporation in Qatar
Qatar Medical Journal 2025, 35 (2025); https://doi.org/10.5339/qmj.2025.35
/content/journals/10.5339/qmj.2025.35
/content/journals/10.5339/qmj.2025.35
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  • Article Type: Research Article
Keyword(s): intensive care unit, postoperative and Unplanned admission

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