The impact of abdominal aortic aneurysm surgery on intensive care unit resources in an Irish tertiary centre

Abstract

Background: The potential impact of surgical service reconfiguration on intensive care unit (ICU) resources needs to be assessed. Aims: To determine the resources required to provide post-operative ICU care to patients undergoing open abdominal aortic aneurysm (AAA) repair or endovascular aneurysm repair (EVAR) at a specialist centre in the HSE South area Methods: For 198 patients, we calculated: (1) ICU bed-days; (2) organ support required; and (3) monetary cost of ICU care. Results: In total, 82.8 % (101/122) of patients undergoing open AAA repair required post-operative ICU care (52 emergency and 49 elective). Emergency cases required more ICU bed-days (median 4.2 vs. 1.9, p < 0.0005) and were more likely to require ventilation (odds ratio, OR 11.7, p < 0.0001), inotropes (OR 3.1, p = 0.01) or enteral nutrition (OR 23.3, p < 0.0001). Mean cost per patient was €3,956 for elective cases and €16,419 for emergency cases. No patient required ICU admission after EVAR (n = 76). Conclusions: Open AAA surgery places significant demands on ICU resources. The planned reconfiguration of surgical services in Ireland must provide for parallel investment in ICU facilities and expertise. © 2012 Royal Academy of Medicine in Ireland.