Triage of surgical patients for intensive care

Abstract

Patients undergoing surgery are at high risk for complications and mortality if they have comorbidities that might impact their outcome, are undergoing a high-risk procedure, or experience complications perioperatively that increase their risk. For some surgical procedures, the postoperative requirements dictate a need for intensive care. But for the majority, there is a specific triage decision that must be made which may be further complicated by a limited availability of ICU beds in some care settings. The use of intensive care services for high-risk patients may improve outcomes, but this remains speculative. Identifying high-risk surgical patients remains difficult, although patient factors, surgical characteristics, risk stratification tools, and biomarkers may help determine which patients may have poor postoperative outcomes and therefore are most likely to receive benefit from intensive care.