Innlagnir á gjörgæslu eftir blaðnám og fleygskurði við lungnakrabbameini

• Main Authors: Tómas Andri Axelsson, Martin Ingi Sigurðsson, Ásgeir Alexandersson, Húnbogi Þorsteinsson, Guðmundur Klemenzson, Steinn Jónsson, Tómas Guðbjartsson
• Other Authors: Landspitali The National University Hospital, University of Iceland, Reykjavik, Iceland.
• Format: Article in Journal/Newspaper
• Language: Icelandic
• Published: Læknafélag Íslands, Læknafélag Reykjavíkur 2012
• Subjects: Lungnakrabbamein; Gjörgæsla; Aged; 80 and over; Carcinoma; Non-Small-Cell Lung; Female; Humans; Iceland; Intensive Care Units; Length of Stay; Lung Neoplasms; Male; Middle Aged; Patient Admission; Pneumonectomy; Postoperative Complications; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; Smella
• Online Access: http://hdl.handle.net/2336/231292

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open Allur texti - Full text INTRODUCTION: Following resection for non-small cell lung cancer (NSCLC), patients are usually admitted to the post-anesthesia care unit (PACU)for a few hours before admission to a general ward (GW). However, some patients need ICU-admission, either immediately post-surgery or from the PACU or GW. The aim of this study was to investigate the indications and risk factors for ICU-admission. MATERIAL AND METHODS: A retrospective study of 252 patients who underwent lobectomy, wedge resection or segmentectomy for NSCLC in Iceland during 2001-2010. Data was retrieved from medical records and patients admitted to the ICU compared to patients not admitted. RESULTS: Altogether 21 patients (8%) were admitted to the ICU, median length-of-stay being one day (range 1-68). In 11 cases (52%) the reasons for admission were intraoperative problems, usually hypotension or excessive bleeding. Ten patients were admitted from the GW (n=4) or PACU (n=6), due to hypotension (n=4), heart and/or respiratory failure (n=4) and reoperation for bleeding (n=2). There were three ICU-readmissions. Patients admitted to the ICU were six years older (p=0.004) and more often had chronic obstructive pulmonary disease and/or coronary artery disease. Tumor size, pTNM-stage, length of operation and the ratio of patients receiving TEA (thoracic epidural anaesthesia) were similar between groups. Over two-thirds of the ICU-patients had minor complications and around half had major complications, compared to 30% and 4%, respectively, for controls. CONCLUSION: ICU-admissions are infrequent following non-pneumonectomy lung resections for NSCLC, these patients being older with cardiopulmonary comorbidities. In half of the cases, admission to the ICU directly follows surgery and ICU-readmissions are few. Inngangur: Eftir brjóstholsskurðaðgerð við lungnakrabbameini eru sjúklingar jafnan lagðir á vöknunardeild í nokkrar klukkustundir áður ...