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Doha: A new study published in the latest edition of the Qatar Medical Journal has revealed significant findings on unplanned intensive care unit (ICU) admissions following elective surgeries in Qatar’s public hospitals.
Conducted across five major hospitals under Hamad Medical Corporation (HMC), the study provides a crucial overview of postoperative complications, highlighting the need for enhanced risk identification and perioperative planning.
The research, titled ‘An Analysis of Unplanned Postoperative ICU Admissions Across Hamad Medical Corporation Hospitals in Qatar’, analysed ICU admissions from January 1 to December 31, 2021.
It focused on admissions that were not anticipated during pre-anesthetic assessments, often resulting from unexpected surgical, anesthetic, or medical complications.
The study provides valuable insight into the state of perioperative care in Qatar’s public hospitals. While the UIA rate is within acceptable limits, continued efforts are necessary to reduce preventable complications.
The authors call for further research and data-driven interventions to enhance surgical safety and optimize critical care resource allocation.
The study analysed a total of 2,087 ICU admissions across five public hospitals in Qatar, identifying 42 cases (2.0%) as unplanned ICU admissions (UIAs) following elective surgeries.
The leading causes of these UIAs were surgery-related complications (57.2%), followed by anesthesia-related (26.2%) and medical-related issues (16.6%). Bleeding emerged as the most common surgical complication, while arrhythmias were the most frequent medical cause.
The mean age of patients with UIAs was 41.83 years, with a gender distribution of 57.1% male and 42.9% female.
The average length of ICU stay for these patients was 2.6 days.
UIAs are considered a key clinical indicator of patient safety and perioperative outcomes.
According to the study, the global rate of UIA ranges between 0.28% and 2.2%. Patients who require ICU admission unexpectedly tend to experience more severe outcomes and longer hospital stays compared to those with planned ICU care.
The study aimed to establish the rate of UIA within HMC hospitals and analyse contributing factors.
These include patient characteristics, surgical complexity, anesthesia-related events, and pre-existing medical conditions.
The study included Hamad General Hospital (HGH); Al Wakra Hospital (AWH); Women’s Wellness and Research Center (WWRC); Hazm Mebaireek General Hospital (HMGH); and Al Khor Hospital (AKH)
The surgical specialties with the highest rates of unplanned ICU admissions were urology (28.6%), followed by general surgery (21.4%), gynecology and obstetrics combined (21.4%), and orthopedics (2.4%).
Among the anesthesia-related cases, complications included aspiration, difficult intubation, delayed recovery, and adverse reactions such as malignant hyperthermia.
The average age of patients was 41.83 years, consistent with Qatar’s younger population demographics. More than half of the patients were overweight or obese, with most classified under ASA Physical Status II, indicating mild systemic disease.
Preoperative evaluation showed that 83.3% of the UIA patients had been assessed in the anesthesia clinic, suggesting that some complications were not foreseeable despite preoperative screening.
The study notes that the 2% UIA rate is within international norms and lower than many previously reported figures, which have ranged as high as 23% to 83% in some settings.
The relatively low rate of anesthesia-related UIAs (26.2%) in this study is also notable, as prior research has recorded rates as high as 55%.
This improvement is attributed to better patient optimization, preoperative evaluation, and adherence to clinical protocols within HMC facilities.
Unplanned ICU admissions increase healthcare costs, extend hospital stays, and elevate stress for both patients and their families.
They also place additional pressure on intensive care units and staff.
The study emphasizes that UIA is a vital metric for quality assessment in surgical care and recommends the development of a standardized screening tool that integrates surgical, anesthetic, and medical risk factors to help prevent avoidable ICU admissions.
