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Bhama PK, Davis GE, Bhrany AD, Lam DJ, Futran ND. The Effects of Intensive Care Unit Staffing on Patient Outcomes Following Microvascular Free Flap Reconstruction of the Head and Neck: A Pilot Study. JAMA Otolaryngol Head Neck Surg. 2013;139(1):37–42. doi:10.1001/jamaoto.2013.1132
Author Affiliations: Division of Facial Plastic Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston (Dr Bhama); Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine, Seattle (Drs Davis, Bhrany, and Futran); and Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio (Dr Lam).
Objective To determine if the implementation of the closed intensive care unit (ICU) at our institution altered clinical outcomes in patients who had undergone microvascular free flap reconstruction of the head and neck by the Otolaryngology–Head and Neck Surgery Service.
Design Retrospective medical chart review.
Setting A single tertiary medical center.
Patients The open ICU cohort had 52 flaps performed on 50 patients, and the closed ICU cohort had 52 flaps performed on 52 patients.
Main Outcome Measures Fifty-two free flap reconstructions of head and neck defects were performed on 50 patients who were admitted to an open ICU. The length of stay (LOS) in the ICU and hospital and incidence of complications were compared with those of 52 patients who underwent 52 free flap reconstructions and were admitted to a closed ICU over a separate period.
Results The mean length of stay in the ICU was 44 and 45 hours in the open and closed ICU cohorts, respectively (P = .90). The incidence of surgical and medical complications was similar in the open and closed ICU cohorts (P > .05).
Conclusions There does not appear to be a significant difference in patient outcome between open and closed ICU care in our study.
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