Admission predictors and clinical patterns of continued intensive care requirement at 48 hours in postoperative patients: a retrospective cohort study

Mustafa Ay; Serap Avcı Ay; Dilara Tüfek Öztan; Şule Asri

Admission predictors and clinical patterns of continued intensive care requirement at 48 hours in postoperative patients: a retrospective cohort study

Abstract

Aims: We investigated whether clinical and bedside physiological variables available at intensive care unit (ICU) admission discriminate postoperative patients who continue to require ICU-level care at 48 hours, and characterized the reasons for this need. Methods: Consecutive adults admitted to the ICU directly after operating-room surgery between January 1 and July 1, 2026 were retrospectively reviewed. The primary outcome was failure to meet at least one of five prespecified clinical domains at 48 hours, or death within 48 hours; patients remaining solely for logistical reasons were not classified as having the outcome. The primary model comprised American Society of Anesthesiologists (ASA) physical status III–V, emergency surgery, intubation at ICU admission and shock index. Results: Of 143 patients, the primary outcome occurred in 39 (27.3%). The primary model yielded an area under the receiver operating characteristic curve (AUC) of 0.820 (95% confidence interval, 0.748–0.891; optimism-corrected, 0.799). Emergency surgery, intubation at ICU admission and a higher shock index were independently associated with the outcome, and adding bedside physiology and level of support improved discrimination (ΔAUC, 0.050; p=0.017). Of the 37 patients with an ongoing requirement, 6 (16.2%) met all four organ-domain criteria and 23 (62.2%) had no early adverse event. Conclusion: A four-variable bedside admission model showed good discrimination for continued ICU-level care requirement at 48 hours or death within 48 hours. This need frequently reflected unresolved acute problems requiring intensive monitoring rather than new organ support. External validation is required.

Keywords

Supporting Institution

None. The authors received no financial support for the conduct or publication of this research.

Ethical Statement

The study was approved by the Clinical Research Ethics Committee of Antalya Training and Research Hospital (Date: 07.08.2026, Decision No: 13/19) and was conducted in accordance with the principles of the Declaration of Helsinki. Because the study was designed retrospectively and used routinely collected anonymized clinical data, the requirement for written informed consent was waived by the ethics committee.

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Details

Primary Language

English

Subjects

Anaesthesiology, Intensive Care

Journal Section

Research Article

Authors

Mustafa Ay ^*
0000-0001-6210-1083
Türkiye

Serap Avcı Ay
0000-0002-3871-9884
Türkiye

Dilara Tüfek Öztan
0000-0003-0242-6307
Türkiye

Şule Asri
0000-0001-9972-7020
Türkiye

Publication Date

October 25, 2026

Submission Date

August 13, 2026

Acceptance Date

October 18, 2026

Published in Issue

Year 2026 Volume: 7 Number: 5

IZ

https://izlik.org/JA87HJ63YG

Cite

RIS / Bibtex

APA

Ay, M., Avcı Ay, S., Tüfek Öztan, D., & Asri, Ş. (2026). Admission predictors and clinical patterns of continued intensive care requirement at 48 hours in postoperative patients: a retrospective cohort study. Journal of Medicine and Palliative Care, 7(5), 1154-1164. https://izlik.org/JA87HJ63YG

AMA

1.Ay M, Avcı Ay S, Tüfek Öztan D, Asri Ş. Admission predictors and clinical patterns of continued intensive care requirement at 48 hours in postoperative patients: a retrospective cohort study. J Med Palliat Care / JOMPAC / jompac. 2026;7(5):1154-1164. https://izlik.org/JA87HJ63YG

Chicago

Ay, Mustafa, Serap Avcı Ay, Dilara Tüfek Öztan, and Şule Asri. 2026. “Admission Predictors and Clinical Patterns of Continued Intensive Care Requirement at 48 Hours in Postoperative Patients: A Retrospective Cohort Study”. Journal of Medicine and Palliative Care 7 (5): 1154-64. https://izlik.org/JA87HJ63YG.

EndNote

Ay M, Avcı Ay S, Tüfek Öztan D, Asri Ş (October 1, 2026) Admission predictors and clinical patterns of continued intensive care requirement at 48 hours in postoperative patients: a retrospective cohort study. Journal of Medicine and Palliative Care 7 5 1154–1164.

IEEE

[1]M. Ay, S. Avcı Ay, D. Tüfek Öztan, and Ş. Asri, “Admission predictors and clinical patterns of continued intensive care requirement at 48 hours in postoperative patients: a retrospective cohort study”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 5, pp. 1154–1164, Oct. 2026, [Online]. Available: https://izlik.org/JA87HJ63YG

ISNAD

Ay, Mustafa - Avcı Ay, Serap - Tüfek Öztan, Dilara - Asri, Şule. “Admission Predictors and Clinical Patterns of Continued Intensive Care Requirement at 48 Hours in Postoperative Patients: A Retrospective Cohort Study”. Journal of Medicine and Palliative Care 7/5 (October 1, 2026): 1154-1164. https://izlik.org/JA87HJ63YG.

JAMA

1.Ay M, Avcı Ay S, Tüfek Öztan D, Asri Ş. Admission predictors and clinical patterns of continued intensive care requirement at 48 hours in postoperative patients: a retrospective cohort study. J Med Palliat Care / JOMPAC / jompac. 2026;7:1154–1164.

MLA

Ay, Mustafa, et al. “Admission Predictors and Clinical Patterns of Continued Intensive Care Requirement at 48 Hours in Postoperative Patients: A Retrospective Cohort Study”. Journal of Medicine and Palliative Care, vol. 7, no. 5, Oct. 2026, pp. 1154-6, https://izlik.org/JA87HJ63YG.

Vancouver

1.Mustafa Ay, Serap Avcı Ay, Dilara Tüfek Öztan, Şule Asri. Admission predictors and clinical patterns of continued intensive care requirement at 48 hours in postoperative patients: a retrospective cohort study. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Oct. 1;7(5):1154-6. Available from: https://izlik.org/JA87HJ63YG