Surgical ICU Preoperative and Postoperative High-Risk Criteria

Counts selected SICU high-risk criteria.

Select whether each criterion is present.

Inputs

Severe preoperative cardiopulmonary disease such as acute MI or COPD

Extensive radical cancer surgery such as esophageal cancer surgery

Severe polytrauma involving multiple organs, systems, cavities, long bones, or pelvis

Major blood loss >1600 mL or >1.5 L/m² in 48 hours

Age >70 with limited major organ physiologic reserve

Shock: MAP<60 mmHg, CVP<5 mmHg, urine<20 mL/h, cool clammy skin

Sepsis: positive blood culture, WBC>12 x10^9/L, fever >38.3°C, chills

Septic shock with leukocytosis, fever, and hypotension <70 mmHg

Severe malnutrition: weight loss >9 kg, albumin <30 g/L, osmolality <280 Osm/L

Respiratory failure: PaO2<60 mmHg, Qs/Qt>30%, or mechanical ventilation

Abdominal emergency such as pancreatitis, bowel necrosis, peritonitis, perforation, or GI bleeding

CVP <15 mmHg after fluid resuscitation

Acute renal failure: BUN>17.85 mmol/L, creatinine>265.2 μmol/L, etc.

Acute liver failure: bilirubin>51.3 μmol/L, albumin<30 g/L, etc.

Anxiety, neurologic depression, stupor, or coma

Sudden postoperative major change: acute MI, pulmonary embolism, major bleeding

Hypotension or unstable vital signs

Intraoperative blood loss about 4000 mL or transfusion >1600 mL whole blood/RBC

Severe infection, visceral perforation, bowel necrosis, pancreatitis, positive blood culture, aspiration pneumonia, etc.

Failure of any major organ

Postoperative fluid/electrolyte disorder with daily infusion >5000 mL

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Important Notice

This resource is intended for educational purposes only and is intended for US healthcare professionals. Healthcare professionals should use independent medical judgment. All decisions regarding patient care must be handled by a healthcare professional and be made based on the unique needs of each patient.