ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Is intensive care necessary after major thoracic surgery? A propensity score-matched study
Talha Dogruyol1, Selime Kahraman1, Sinem Dogruyol2, Mesut Buz1, Berk Cimenoglu1, Attila Ozdemir1, Fatih Dogu Geyik3, Recep Demirhan1
1Department of Thoracic Surgery, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Türkiye
2Emergency Medicine, Haydarpaşa Numune Training and Research Hospital, Istanbul, Türkiye
3Department of Anesthesiology and Reanimation, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2023.23501
Background: This study aims to compare the surgical results, complications, mortality rates, and inpatient costs in two patient groups followed, whether in the intensive care unit or general ward after a major thoracic procedure and to examine clinical and surgical factors related to the development of complications.

Methods: Between January 2018 and June 2021, a total of 485 patients (150 males, 335 females; mean age: 58.3±13.2 years; range, 22 to 86 years) who underwent a major thoracic surgery in our clinic were retrospectively analyzed. The patients were divided into two groups as the intensive care unit patients (n=254) and general ward patients (n=231). In the former group, the patients were followed in the intensive care unit for a day, while in the general ward group, the patients were taken directly to the ward. The groups were compared after propensity score matching. All patients were analyzed for risk factors of morbidity development.

Results: After propensity score matching, 246 patients were enrolled including 123 patients in each group. There was no statistically significant difference between the groups in any features except for late morbidity, and inpatient costs were higher in the intensive care unit group (p<0.05). In the multivariate analysis, age, American Society of Anesthesiologists Class 3, and secondary malignancy were found to be associated with morbidity (p<0.05).

Conclusion: In experienced centers, it is both safe and costeffective to follow almost all of the major thoracic surgery patients postoperatively in the general ward.

Keywords : General ward; intensive care; lung resection; major thoracic surgery; monitorization
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