The Incidence, Characteristics and Outcomes of Pneumothorax in Thai Surgical Intensive Care Units (Thai-SICU Study).

Objective: To identify incidence, characteristics, and outcomes of pneumothorax among patients who specifically stayed in surgical intensive care units (SICUs). Material and Method: This was a multicenter prospective cohort study conducted in 9 University-affiliated SICUs in Thailand. Incidence of pneumothorax and its outcomes were evaluated from April 2011 to January 2013. Results: 4,652 patients who were admitted to SICU were enrolled. The incidence of pneumothorax was 0.5% (25 cases) in our study. Significant characteristics were found in the pneumothorax group, including: lower BMI, underlying malignancy and COPD, higher APACHE-II and SOFA score within 24 hours of first ICU admission, pulmonary infiltration pattern of chest imaging and usage of mechanical ventilation. In terms of outcome, there were higher SICU mortality and 28-day hospital mortality in pneumothorax than non-pneumothorax patients at 28.0% vs. 9.6%, p = 0.002 and at 44.0% vs. 13.6%, p<0.001, respectively. Conclusion: Patients admitted to surgical intensive care units who developed pneumothorax had higher risk of intensive care unit mortality and 28-day hospital mortality than non-pneumothorax patients, as well as a longer intensive care unit and hospital length of stays.

The Incidence, Characteristics, and Outcomes of Stroke and Seizure In Critically Ill Surgical Patients: A Multicenter Cohort Study of Thai Surgical Intensive Care Units (THAI-SICU Study).

Objective: To explore the incidence, characteristics, and outcomes of patients affected with new onset of stroke and seizure in the surgical intensive care unit (SICU). Material and Method: This study identified new onset of stroke and seizure in 4,652 patients admitted to our multicenter prospective cohort study, a collaboration of nine university-affiliated surgical ICUs in Thailand between April 2011 to January 2013. Results: The authors found new stroke and seizure events at 0.2% and 1%, respectively. The significant characteristics found in stroke and seizure patients included: reason for ICU admission, American Society of Anesthesiologists (ASA) physical status classification, and severity of patients at ICU admission (evaluated by APACHE-II and SOFA day score in first 24 hours of ICU admission). In terms of outcomes, there was higher ICU mortality in both stroke and seizure groups than in nonstroke and non-seizure groups (18% vs. 36% vs. 9%, p<0.001, respectively). In addition, ICU length of stay among stroke and seizure patients was also longer than non-stroke and non-seizure groups (6 (4-18) vs. 10 (4-16) vs. 2 (1-4) days, p<0.001, respectively). However, multivariable regression analysis showed a statistical significance only in longer duration of ICU stay in stroke (6.07 days; 95% CI: 3.34-8.80) and seizure (3.88 days; 95% CI: 2.15-5.62) when compared with nonstroke and non-seizure patients, adjusted by ASA, APACHE-II and SOFA score). Conclusion: From Thai-SICUs study, patients admitted to surgical ICU who developed new episodes of stroke and seizure had longer ICU length of stay when adjusted by their severity score.