Intensive care monitoring after total joint replacement

Abstract

Patient safety is a critical issue in elective total joint replacement surgery. Identifying risk factors that might predict complications and intensive care unit (ICU) admission proves instrumental in reducing morbidity and mortality. The institution's experience with risk stratification and pre-operative ICU triage has resulted in a reduction in unplanned ICU admissions and post-operative complications after total hip replacement. The application of the prediction tools to total knee replacement has proven less robust so far. This work also reviews areas for future research in patient safety and cost containment. Patient safety has come to the forefront of both government and lay scrutiny.

Development and Validation of a Multivariable Prediction Model for Postoperative Intensive Care Unit Stay in a Broad Surgical Population

“…Accurate preoperative prediction of surgical patients requiring postoperative ICU care could prove useful in allocating this precious resource. We identified 26 studies over the past 20 years related to predicting postoperative ICU use. Most of the studies (77%) covered specific types of surgery and thus were not generalizable to broad surgical populations .…”

“…We identified 26 studies over the past 20 years related to predicting postoperative ICU use. Most of the studies (77%) covered specific types of surgery and thus were not generalizable to broad surgical populations . Six studies included broader surgical populations, but 3 studies had small sample sizes (100 to 6000 patients), and 1 study included both preoperative and intraoperative predictors, making it not useful for prediction in the preoperative period .…”