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Effects of the intermediate care unit on the oldest-old general surgical patients: a retrospective, pre- and postintervention study

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Abstract

Background

Whether the intermediate care unit (IMCU) is beneficial for the oldest-old (aged ≥ 80 years) general surgical patients still remains unknown. We aimed to investigate the impacts of IMCU on the clinical outcomes and cost in this population.

Methods

A retrospective, pre- and postintervention study was performed in this population in a university teaching hospital. The primary outcome was the occurrence of life-threatening complications including death or unplanned ICU admission after the surgeries. Secondary outcomes included the comparisons of the hospitalization expenses, the hospital length of stay (LOS) and the postoperative LOS between the pre-IMCU group and the IMCU group.

Results

Two hundred and seventeen patients were enrolled, including 98 in the pre-IMCU group and 119 in the IMCU group. After the introduction of IMCU, the occurrence of life-threatening complications significantly dropped from 11.2 to 2.5% (P = 0.012). The total hospitalization expenses showed a nonsignificant decreasing trend in the IMCU group (pre-IMCU group: 85856.3 ± 66583.7 RMB vs IMCU group: 78936.4 ± 36710.4 RMB). The treatment fee was much lower in the IMCU group (IMCU group: 4930.0 ± 4280.2 RMB vs pre-IMCU group: 7378.2 ± 10096.7 RMB, P = 0.017). Both the hospital LOS (IMCU group: 20.3 ± 10.3 days vs pre-IMCU group: 19.5 ± 9.0 days) and the postoperative hospital LOS (IMCU group: 12.0 ± 8.1 days vs pre-IMCU group: 11.2 ± 7.0 days) were not statistically different in the two groups.

Conclusions

The allocation of the oldest-old surgical patients who do not need organ support therapy in the ICU to IMCU rather than in the standard wards was associated with a significant decrease in postoperative life-threatening complications and treatment fee.

Trial registration

This study was registered at https://www.chictr.org.cn (ChiCTR2000030639).

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Data availability

The datasets in this study are available from the corresponding author on reasonable request.

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Acknowledgements

We especially thank the staff in the department of Information in our hospital who made the data collection and evaluation possible.

Funding

This work did not receive any grant from funding agencies in the public, commercial or not-for-profit sectors.

Author information

Author notes

  1. Lichun Wang and Junpu Qing contributed equally to this work.

Authors and Affiliations

  1. Department of Intensive Care Unit, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China

    Lichun Wang, Xiaofei Zhang & Lei Chen

  2. Department of Operation Management, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China

    Junpu Qing & Lin Yao

  3. Department of Information, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China

    Zheqing Li

  4. Key Laboratory of Diabetology of Guangdong Province, Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China

    Wen Xu

Authors
  1. Lichun Wang
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  4. Lei Chen
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  5. Zheqing Li
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  6. Wen Xu
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  7. Lin Yao
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Contributions

All authors attest that they meet the current International Committee of Medical Journal Editors (ICMJE) criteria for Authorship. LW contributed to methodology, formal analysis, investigation and writing the original draft; JQ contributed to formal analysis and investigation; XZ contributed to resources and visualization; LC helped in verification. ZL contributed to data curation; WX helped in conceptualization, methodology, writing, review and editing; LY helped in conceptualization, methodology and supervision.

Corresponding authors

Correspondence to Wen Xu or Lin Yao.

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Conflict of interest

The authors have declared no conflicts of interest for this article.

Ethical approval

The protocol was approved by the Institutional Ethics Committee of the Six Affiliated Hospital of Sun Yat-sen University.

Informed consent

A waiver for informed consents was allowed by the ethic committee in view of the fact that data in this study were analyzed retrospectively and anonymously.

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Wang, L., Qing, J., Zhang, X. et al. Effects of the intermediate care unit on the oldest-old general surgical patients: a retrospective, pre- and postintervention study. Aging Clin Exp Res 33, 1557–1566 (2021). https://doi.org/10.1007/s40520-020-01662-5

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  • DOI: https://doi.org/10.1007/s40520-020-01662-5

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