To determine the current status of surgical rescue (SR) and examine the predictors of failure to rescue (FTR) in acute care surgery, particularly in non-trauma patients.
Key Findings:
Patients were divided into survival (122) and mortality (20) groups, with significant implications for clinical practice.
Higher ASA-PS and qSOFA scores were observed in the mortality group, indicating a need for targeted interventions.
Independent prognostic factors for FTR included ASA-PS ≥ 3, complications from non-surgical therapy, and qSOFA score ≥ 2, highlighting critical areas for preoperative assessment.
The SRSS effectively stratified short- and long-term prognoses, providing a valuable tool for clinicians.
Interpretation:
Predictors of FTR in surgical rescue include ASA-PS ≥ 3, qSOFA score ≥ 2, and complications from non-surgical therapy, which can guide preoperative prognostic assessments and improve patient outcomes.
Limitations:
Retrospective design may introduce bias, limiting the ability to establish causation.
Findings may not be generalizable beyond the studied institution, suggesting the need for multicenter studies.
Conclusion:
The study identifies critical predictors of FTR in surgical rescue and establishes a scoring system to aid in prognosis assessment, emphasizing the need for further research.
Patients with preoperative vitamin D deficiency had higher postoperative pain scores and opioid use after mastectomy, including more than triple the odds of moderate to severe pain within 24 hours of surgery.
