Læknablaðið - 15.05.2012, Blaðsíða 15

RANNSÓKN
Þakkir
Þakkir fá Gunnhildur Jóhannsdóttir skrifstofustjóra og starfsfólk
skjalageymslu Landspítala í Vesturhlíð fyrir aðstoð við að afla
sjúkraskráa. Loks fær Axel F. Sigurðsson hjartalæknir þakkir fyrir
yfirlestur og góðar ábendingar.
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ENGLISH SUMMARY
Intensive care unit admissions following lobectomy or sublobar resections
for non-small cell lung cancer
Axelsson TA, Sigurdsson Ml, Alexandersson A, Thorsteinsson H, Klemenzson G, Jonsson S, Gudbjartsson T
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 investi-
gate 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 lceland 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 rea-
sons 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-read-
missions. 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, comp-
ared to 30% and 4%, respectively, for controls.
Conclusion: ICU-admissions are infrequent following non-pneumo-
nectomy 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.
Key words: Intensive care, post-anesthesia care unit, lung cancer, operation, thoracotomy, readmission, complications.
Correspondence: Tómas Guðbjartsson, tomasgud@landspitali.is
Faculty of Medicine, University of lceland, Departments of Cardiothoracic Surgery, Anesthesia and tntensive Care and Pulmonology
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