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Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery: Secondary Analysis Of POWER Trial

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

The efficacy of routine admission of high-risk patients to a critical care unit after surgery is not clear. The aim of our study was to investigate the association between critical care admission after scheduled colorectal surgery and postoperative complications, 30-day mortality, and length of stay in hospital.

Methods

A pre-defined secondary substudy of POWER study was performed. POWER study was a prospective multicenter observational study of patients undergoing elective primary colorectal surgery during a single period of two months of recruitment between September and December 2017.

Results

A total of 2084 patients from 80 Spanish hospitals were included, of which 722 (34.6%) were admitted to critical care unit (CCU) after elective surgery. After adjusting for confounding factors in the multivariate analysis, postoperative CCU admission was independently associated with a higher incidence of moderate-to-severe postoperative complications (adjusted OR 1.951, 95% CI 1.570, 2.425; p < 0.001). Regarding secondary outcomes, postoperative critical care admission was independently associated with higher 30-day mortality (adjusted OR 6.736; 95% CI 2.507, 18.101; p < 0.001) and independently associated with an increased hospital length of stay (adjusted OR 1.143, 95% CI 1.112, 1.175; p < 0.001).

Conclusions

Direct admission to CCU after scheduled colorectal surgery was not associated with a reduction in moderate-to-severe postoperative complications.

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Acknowledgements

Statistical analyses were performed by the Biostatistics Unit of Hospital Universitario La Paz, Madrid, Spain.

  The POWER investigators group

  (* Principal Investigator at each site).

  Complejo Asistencial Universitario de León

  Cristina GARCIA-PEREZ*, Eva HIGUERA-MÍGUELEZ, José M. MARCOS-VIDAL, María MERINO-GARCÍA, Ana B. RUBIO-LÓPEZ, María E. PASCUAL-DIEZ Dept of Anesthesiology Complejo Asistencial de Segovia Francisco J. GARCÍA-MIGUEL; Dept of Anesthesiology Complejo Asistencial de Zamora Luis R. CABEZUDO-SANJOSE *, Ruth MARTÍNEZ-DÍAZ, Sara ALEGRÍA-REBOLLO Dep. General Surgery; José L. GONZÁLEZ-RODRÍGUEZ *, María S. VEGA-CRUZ, Gema MARTÍNEZ-RAGÜÉS, Dep. Anesthesia and Critical Care. Complejo Universitario Asistencial de A Coruña Manuel A. GÓMEZ-RÍOS*, Eva MOSQUERA-RODRÍGUEZ, Sara DEL-RÍO-REGUEIRA, Dept of Anaesthesiology and Perioperative Medicine. Complejo Hospitalario de Navarra, Pamplona José R. PEREZ-VALDIVIESO * Marta MARTIN-VIZCAINO * Susana HERNANDEZ-GARCIA, Francisco J. YOLDI-MURILLO, Miguel SALVADOR-BRAVO, Manuela RUBIAL-ALVAREZ, Dep. Anaesthesiology; Fabiola OTEIZA-MARTINEZ, Enrique BALEN-RIVERA, Dep. Surgery; José A. GARCIA-ERCE. Director Blood and Tissue Bank of Navarra; Ana ZUGASTI-MURILLO, María E. PETRINA-JÁUREGUI, Nutrition and Endocrinology Department. Complejo Asistencial Universitario de Salamanca Domingo BUSTOS-GARCÍA*, María P. SÁNCHEZ-CONDE, Antonio RODRÍGUEZ-CALVO, María A. HERNÁNDEZ-VALERO; Dep. Anesthesiology; María ANGOSO-CLAVIJO, Luis M. GONZÁLEZ-FERNÁNDEZ Dep. Surgery. Miguel A. BRAVO-RIAÑO, María V. ARNES-MUÑOZ Dep. Nursery. Complejo Hospitalario de Toledo Filadelfo BUSTOS-MOLINA, Daniel PAZ-MARTÍN, Bárbara VÁZQUEZ-VICENTE, Lourdes GONZÁLEZ-LÓPEZ, Conrado MÍNGUEZ-MARÍN Dep. Anesthesiology Complejo Hospitalario y Universitario de Pontevedra Susana DIZ-JUEGUEN* Jaime SEOANE-ANTELO, Julio BALLINAS-MIRANDA, Ester CARRERA-DACOSTA, Erica BARREIRO-DOMÍNGUEZ, Alexandra PIÑEIRO-TEIJEIRO, Raquel SANCHEZ-SANTOS, Dep. General Surgery; Marina VARELA-DURAN*, Pilar DIAZ-PARADA, Dep Anesthesia and Critical Care.

Fundación Hospital del Espíritu Santo; Santa Coloma de Gramanet Aránzazu CALERO-LILLO*Manuel Ángel LÓPEZ-LARA, Salvador MUÑOZ-COLLADO, Juan VALVERDE-SINTAS, Silvia AZNAR-PUIG, Daniel TROYANO-ESCRIBANO Dep. Colorectal Surgery. Hospital 2 de Mayo, Barcelona Sandra MARMAÑA-MEZQUITA*, Jesús FERNANZ-ANTÓN Dep. Anesthesia and Critical Care; Lucia CATOT-ALEMANY, Dep.General and Digestive Surgery Hospital Clínic Universitat de Barcelona Jaume BALUST*, Marta UBRÉ*, Carlos FERRANDO-ORTOLÁ, Graciela MARTÍNEZ-PALLÍ Dep. Anesthesiology; Ainitze Ibarzabal, Antonio M. Lacy Dep. General and Digestive Surgery Hospital Clínico San Carlos, Madrid Rubén SÁNCHEZ-MARTÍN *, Karina MARTINS-CRUZ, Paula PÉREZ-JIMÉNEZ Dep. Anesthesiology. Hospital Clínico Universitario Lozano Blesa, Zaragoza Rubén Casans-Francés*, Javier Longás, Dep. Anesthesiology. José M. Ramírez Rodríguez* Manuela Elia Dep.General and Digestive Surgery. Hospital Clínico Universitario de Valencia Ana Mugarra-Llopis*, Cristina Crisan, Estefanía Gracia-Ferrándiz, Esther Romero-Vargas, Marina Soro-Domingo, Dep. Anesthesiology. Hospital Clínico de Valladolid Rita RODRÍGUEZ-JIMÉNEZ*, Blanca PRADA-MARTIN, Henar MUÑOZ-HERNÁNDEZ, José I. GÓMEZ HERRERAS, Sara COCHO-CRESPO, Sandra FERNÁNDEZ-CABALLERO, Miguel FLORES-CRESPO, Andrea VÁZQUEZ-FERNÁNDEZ, Dep. Anesthesiology. Hospital Comarcal de Inca Carlo BRUGIOTTI*, Estefanía OLLÉ-SESE Dep.General Surgery. Hospital Comarcal de Laredo Carla R. HOUGHTON-ACUÑA*, Marta LÓPEZ-DOUCIL, Dep. Anesthesiology. Hospital Comarcal de Vinaroz Ernesto A. TARAZONA-LÓPEZ* Iván BEL-MARCOBAL, Sonia GONZÁLEZ-COGOLLOR Dep. Anesthesiology. Hospital Costa del Sol, Marbella Manuel LLÁCER-PÉREZ*, Alberto ARIAS-ROMANO, María C. ARRABAL-TABORDA, Mercedes CABALLERO-DOMÍNGUEZ, Rafael GARCÍA-LÓPEZ, Julio ONTORIA-MURIEL, Antonio VIVÓ-BLASCO, Dep. Anesthesiology. Hospital Don Benito-Villanueva de la Serena Enrique DEL-COJO-PECES*, Jose M. TENA-GUERRERO*, Dep. Anesthesiology. Hospital General Mateu Orfila, Menorca Fernando ALCALDE MATAS*, Hernán GIORDANO, Dep.General Surgery. Hospital General Universitario Gregorio Marañón, Madrid Jose M PEREZ PEÑA*, Luis OLMEDILLA-ARNAL, Pilar BENITO-SAZ, Elena LÓPEZ-GIL, Adela RUIZ-ORTEGA, Sara ZAPATERO-GARCÍA, Dep. Anesthesiology. Emilio DEL-VALLE-GARCÍA. Dep. General Surgery. Hospital General Universitario José María Morales Messeguer, Murcia Víctor SORIA-ALEDO*, Carmen V PÉREZ-GUARINOS, Enrique PELLICER-FRANCO, Graciela VALERO-NAVARRO, Mónica MENGUAL-BALLESTER, José Andrés GARCÍA-MARÍN Dep. Coloproctology. Hospital General Universitario de Alicante.

Manuel ROMERO-SIMÓ * Ibán CARAVACA-GARCÍA *, Teresa BLASCO-SEGURA, Carlos F. CAMPO-BETANCOURTH, Rafael David COSTA-NAVARRO, Dep. General and Digestive Tract Surgery. Colorectal Surgery Unit.Hospital General Universitario de Castellón Laura JORDÁ-SANZ*, María I. DE-MIGUEL-CABRERA, José M. ESPAÑA-PAMPLONA, Dep. Anesthesiology. Hospital General Universitario de Ciudad Real Silvia GIL-TRUJILLO*, Francisco J. REDONDO-CALVO*, Víctor BALADRÓN-GÓNZALEZ, Remedios MORENO-BALLESTEROS Dep. Anesthesiology. Hospital General Universitario de Elche José L. MUÑOZ-RODES*, Elena MIRANDA Dep. Anesthesiology. Hospital General Universitario de Valencia Marta ROSELLÓ-CHORNET*, Lourdes ALÓS-ZARAGOZA, Juan CATALÁ-BAUSET, María A. PALLARDO-LÓPEZ, Noemí ALMENARA-ALMENARA, Lorena MUÑOZ-DEVESA Dep. Anesthesiology.

Hospital General de La Palma, Santa Cruz de Tenerife Benito ALCAIDE-PARDO Dep. Surgery. Hospital Nuestra Señora del Prado, Talavera de la Reina.

Pablo GIMENO-FERNÁNDEZ*, José L. GÓMEZ-AGRAZ, Carla IGLESIAS-MORALES, Paola B. ORDOÑEZ-ENIREB, Ana M. RÍOS-VILLALBA, Joselvy RODRÍGUEZ-PINTO, Sergio SÁNCHEZ-CORTÉS Dep. Anesthesiology. Hospital Rafael Méndez, Lorca María J. MONTOYA-TABARES*, Vicente RUIZ, Francisco GONZÁLEZ-SÁNCHEZ, Víctor SORIANO-GIMÉNEZ V. Dep. Surgery. Hospital Reina Sofía, Murcia José M MUÑOZ-CAMARENA*, Jorge BENAVIDES-BULEJE Dep. Surgery. Hospital Rey Juan Carlos, Móstoles Juan C ESTUPIÑÁN-JIMÉNEZ.* Irene PORTERO-LARRAGUETA.*Dep. Anesthesiology. David ALIAS. Dep. Surgery. Hospital Universitari Mútua Terrassa Carlos MARISTANY-BIENERT *, José A. PARDO-LÓPEZ Dep. Surgery. Hospital Universitario 12 de Octubre, Madrid Álvaro RAMIRO-RUIZ*, Pablo GARCÍA, Arantza MARTÍNEZ-DE-GUEREÑU, Belinda MONTALBÁN, Claudia OLEA, David BENGURÍA, Javier SILVA, Adriana CALDERÓN. Dep. Anesthesiology. Hospital Universitario Arnau de Vilanova, Lleida Jordi ESCOLL-RUFINO*, Carlos CERDAN-SANTACRUZ, José E. SIERRA-GRAÑÓN, María RUFAS-ACÍN, Nuria MESTRES-PETIT Dep. Surgery. Ingrid C. PENAGOS-SAAVEDRA Dep. Anesthesiology. Cristina MORENO-CASTILLA Dep of Endocrinology & Nutrition. Jordi RIERA-RIU Dep of Nursing.

Hospital Universitario Central de Asturias, Oviedo Ana CUELLAR-MARTÍNEZ*, RC GONZÁLEZ-ÁLVAREZ Dep. Anesthesiology. Hospital Universitario Fundación Alcorcón Míriam SÁNCHEZ-MERCHANTE*, Santiago GARCÍA-DEL-VALLE-Y-MANZANO, Sara GARCÍA-ZAMORANO, Natalia GIJÓN-HERREROS, Patricia ROBLES-ÁNGEL Dep. Anesthesiology. Hospital Universitario de Getafe Enrique ROCA-CASTILLO*, María L. MARISCAL-FLORES, Mario MORALES-CAYUELA, Irene ALONSO-RAMOS Dep. Anesthesiology. Virginia JIMÉNEZ-CARNEROS* Lucas CASALDUERO-GARCIA, Javier JIMENEZ-MIRAMÓN, José L. RAMOS-RODRÍGUEZ Dep. Surgery. Hospital Universitario Infanta Leonor, Madrid Ane ABAD-MOTOS*, Alfredo ABAD-GURUMETA, Norma ARACIL-ESCODA, Eugenio MARTÍNEZ-HURTADO, Beatriz NOZAL-MATEO, Elena SÁEZ-RUIZ, Rut SALVACHUA-FERNÁNDEZ, Javier RIPOLLÉS-MELCHOR Dep. Anesthesiology. María L. DE-FUENMAYOR-VALERA Dep. Surgery. Elena SÁNCHEZ, Begoña TORIBIO Dep. Nursey Hospital Universitario Insular de Gran Canaria.

Antonio NAVARRO-SÁNCHEZ*, José LÓPEZ-FERNÁNDEZ, Dácil MONTESDEOCA CABRERA, Francisco J. ALCALÁ-SERRANO Dep. Surgery. Hospital Universitari i Politécnic La Fe, Valencia María J. ALBEROLA-ESTELLÉS*, Óscar DÍAZ-CAMBRONERO, María S. MATOSES-JAÉN. Dep. Anesthesia and Critical Care, Perioperative Medicine Research Group. María D. RUIZ-BOLUDA. Dep. Anesthesia and Critical Care Hospital Universitario La Paz, Madrid Azahara SANCHO-DE-AVILA*, Sofia DIAZ-CARRASCO, Almudena MARTÍN-MARTÍN, Alejandro SUÁREZ-DE-LA-RICA, Rafael UÑA-OREJÓN, Emilio MASEDA Dep. Anesthesiology Hospital Universitario Marqués de Valdecilla, Santander Guillermo TEJÓN-PÉREZ*, María V. ALFARO-MARTÍNEZ, Marta ALONSO-FERNÁNDEZ, María A. ÁLVAREZ-CEBRIÁN, María J. ÁLVAREZ-DEL-VAYO-RODRÍGUEZ, Mariana CARRILLO-RIVAS, María FERNÁNDEZ-RODRÍGUEZ, Sonia TRABANCO-MORÁN, José L. RÁBAGO-MORÁN Dep. Anesthesiology Hospital Universitario Miguel Servet, Zaragoza Javier MARTÍNEZ-UBIETO * Ana M. PASCUAL-BELLOSTA*, Sonia M. ORTEGA-LUCEA, Maria P. SANTERO-RAMIREZ, Maria V. DUQUE-MALLEN, Cristian ARAGON-BENEDI Dep. Anesthesiology Hospital Universitario ParcTaulí, Sabadell Andrea VALLEJO-TARRAT*, Carmen COLILLAS-CALVET, Maria J. LASO, Javier MARTINEZ-CABAÑERO Dep. Anesthesiology Hospital Universitario Príncipe de Asturias, Alcalá de Henares Javier HERNÁNDEZ-SALVÁN*, Beatriz LEDESMA-MUÑOZ, Carolina OCHOA-OSORIO, Máximo SANZ-GARCÍA, Begoña HERRERO-GARROTE Dep. Anesthesiology. Alma BLÁZQUEZ-MARTIN, Manuel DÍEZ-ALONSO, Pilar HERNÁNDEZ -JUARA, José M. MUGUERZA-HUGUET Dep. Surgery. Hospital Universitario Puerta de Hierro, Majadahonda Macarena BARBERO-MIELGO*, Belén SAN-ANTONIO-SAN-ROMÁN*, Laura ALONSO-AGUILAR, Viktoria MOLNAR Dep. Anesthesiology Hospital Universitario Puerta del Mar, Cádiz María C. DELGADO-NAVIERO* Encarnación MELÉNDEZ-LEAL Dep. Anesthesiology Hospital Universitario Quirón Madrid Virginia CAVERO-GARCÍA*, África FERNÁNDEZ-SÁNCHEZ, Daniela A. CUBEK-QUEVEDO, Rocío DÍEZ MUNAR, Francisco J. BLÁZQUEZ-FERNÁNDEZ-DE-LA PRADILLA Dep. Anesthesiology Hospital Universitario Ramón y Cajal, Madrid Serrano AB*, Balvís A, Berruezo A, Esparza E, De la Hoz I, Palavicini A, Pereira L, Vega X, Villahoz J, Villanueva G Dep. Anesthesiology Hospital Universitario Río Hortega, Valladolid.

José I. ALONSO-FERNÁNDEZ*,César ALDECOA*, Clara BOLAÑO-PÉREZ, Teresa VILLÁN-GONZÁLEZ Dep. Anesthesiology Hospital Universitario Sant Pau, Barcelona Astrid Batalla.*, G. AZPARREN, M. BASTTITA, M. FELIPE, L. CUEVA, Marta GINE, A.M. GÓMEZ-CARO, I. INDIA, S. PIÑOL Dep. Anesthesiology Hospital Universitario Son Espases Neus ESTEVE-PÉREZ* Carlos MORA-FERNÁNDEZ, Ana FERRER-ROBLES Dep. Anesthesiology; Juan J. SEGURA –SAMPEDRO*, Natalia ALONSO- HERNÁNDEZ Dep. Surgery. Hospital Universitario Valld´Hebrón, Barcelona Ángels CAMPS-CERVANTES *, Ivette CHOCRÓN-DA-PRAT, Carolina C. CORONADO-SILVA, Héctor DUQUE-SANTOS, Elena ESCLAPEZ-SEMPERE, Patricia GALAN-MENÉNDEZ, Silvia MATARÍN-OLMO, M. P. TORMOS-PÉREZ, Laura VILLARINO- VILLA Dep. Anesthesiology Hospital Universitario Virgen Macarena, Sevilla Héctor BERGÉS-GUTIÉRREZ*, Miguel AISA-GASCA, Verónica ARBONA-CAMILLERO, José D. BAUTISTA-GONZÁLEZ, Francisco J. CARBALLIDO-PASCUAL, Mercedes GUTIÉRREZ-MORENO, Ana MUÑOZ-DURÁN Hospital Universitario Virgen de Valme, Sevilla.

Jesús CAÑETE-GÓMEZ, Esther CÁCERES-FABREGA, José M. LORENTE-HERCE, Octavio MULET-ZAYAS Dep. Surgery Hospital Universitario Virgen de la Victoria, Málaga Rocío GÓMEZ-PÉREZ*, Cristina MONJE-SALAZAR*, Luis LOBATO-BANCALERO, Carmelo TORRES-MORENO, Elena SANCHEZ-CÁRDENAS, Juan J. DAZA-GONZÁLEZ, Teresa SANCHEZ-VIGUERA, Antonio DEL-FRESNO-ASENSIO Dep. Surgery. Laura BERMUDEZ-ROMÁN Dep. Anesthesiology. Hospital Universitario de Burgos Rodrigo SANLLORENTE-SEBASTIAN*, Maria C VILLALAIN-PEREZ, Mihaela SICLAMA-STROE, Judith BENÍTEZ-VILLAR Dep. Anesthesiology Hospital Universitario de Cruces, Baracaldo Alberto SÁNCHEZ-CAMPOS*, Alberto MARTÍNEZ-RUIZ, Dep. Anesthesiology. Patricia ALONSO-CARNICERO Dep. Surgery Hospital Universitario de Fuenlabrada Francisco J. DE-LA-TORRE-GONZÁLEZ*, Carolina NARANJO-CHECA, Fernando PEREIRA-PÉREZ, Elena RUIZ-UCAR, Alfredo RIVERA Dep. Surgery. Cristina GIL-LAPETRA Dep. Anesthesiology. Hospital Universitario de Gran Canaria Doctor Negrín Eva M. NOGUÉS-RAMIA*. Yolanda SOSA-QUESADA, Alonso GÓMEZ, Dep. Surgery Hospital Universitario de Guadalajara Laura M. MARTÍNEZ-MECO-ORTIZ*, Mercedes CABELLOS-OLIVARES*, José R. RODRÍGUEZ-FRAILE Dep. Anesthesiology. María LABALDE-MARTÍNEZ. Dep. Surgery.

Hospital Universitario de Móstoles Beatriz NACARINO-ALCORTA*, Raquel FERNÁNDEZ-GARCÍA*, Borja DE-LA-QUINTANA-GORDON Dep. Anesthesiology. Justyna DREWNIAK, Fátima SENRA-LORENZANA Dep. Surgery Hospital Universitario de Torrejón Pablo GALINDO-JARA*, Ana B. GALLARDO-HERRERA, Cesar GARCÍA-LLORENTE, Laura COLAO-GARCÍA Dep. Surgery. Luz-Divina RELLAN-ÁLVAREZ*. Miguel MIRO-MURILLO, Sahely-CLARET FLORES-RISCO Dep. Anesthesiology. Hospital Universitario de Vic.

Jordi SERRAT-PUYOL*, Dep. Anesthesiology. Adrian MEDINA-GALLARDO, Yuhami MITSAHID-CURBELO-PEÑA Dep. Surgery. Hospital Universitario de Álava Margarita LOGROÑO-EJEA* Dep. Anesthesiology. Hospital Virgen de los Lirios de Alcoy José L. JOVER-PINILLOS *, Dep. Anesthesiology. Francisco J. ORTS-MICÓ *, Dep. Surgery. Hospital Virgen del Puerto, Plasencia.

Coral CÓZAR-LOZANO*, Olga BLASCO-DELGADO, Andrea NONNEMACHER-SAN-JULIÁN*, José A. PÉREZ Dep. Surgery Laura DURÁN CRUCES Dep. Anesthesiology. Hospital de Alzira Francisco J. BLANCO Dep. Surgery Hospital de Galdacano-Usansolo Aitor LANDALUCE-OLAVARRIA *, Izaskun BADIOLA, Marta CALVO, Unai DE-ANDRES, Vicente PORTUGAL-PORRAS, Bakarne UGARTE-SIERRA Dep. Surgery Hospital de Igualada Ana PEDREGOSA-SANZ*, Laura PERELLÓ-CERDÀ*, Yobanys RODRÍGUEZ-TÉLLEZ, Joanna GRÖSSL-MELEÁN Dep. Anesthesiology. Xavier VIÑAS-TRUÑÉN Dep. Surgery Hospital de La Princesa, Madrid Enrique ALDAY-MUÑOZ* Dep. Anesthesiology. Elena BERMEJO-MARCOS*, Pedro A. ALONSO-CASADO, Francisco A. GIMENO-CALVO, Ana RODRIGUEZ-SÁNCHEZ, Carmen MONTES-LÓPEZ Dep. Surgery Hospital de Manacor Laura ÁLVAREZ-LLANO* Dep. Surgery Hospital de Manises María J. FAS-VICENT*, Juan M. ORTEGA-MONZÓ Dep. Anesthesiology Hospital de Mérida Gustavo FLORES-FLORES* José L TRISTANCHO Dep. Anesthesiology Hospital de Sant Joan Despí Moisès Broggi. Consorci Sanitari Integral. Sandra MARMAÑA-MEZQUITA*, Montserrat BAYO-SANS, María C. DEIROS-GARCIA, Jesús FERNANZ-ANTÓN, María L. GIL-GÓMEZ, Lourdes PARRA, Vanesa TEJEDOR-DE-LA-FUENTE, Dep. Anesthesiology. Carlos JERICÓ-ALBA, Dep. Internal Medicine. Núria BORRELL-BRAU David CAMACHO-MARTÍN Dep. Nursery Jose L. ORTIZ-DE-ZARATE Dep. Surgery Hospital de Viladecans Daniel LÓPEZ-RUIZ*, Vicens RODRIGUEZ-BUSTAMANTE Dep. Anesthesiology. MARTINEZ-VILALTA M Dep. Surgery. Hospital del Mar, Barcelona Daniel AMOROS-RUIZ*, Marc SADURNI-SARDA Dep. Anesthesiology. OSI Alto Deba Pablo RENEDO-CORCÓSTEGUI Dep. Anesthesiology.

Funding

The POWER study was supported by the Spanish Perioperative Audit and Research Network (REDGERM).

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Surgical Critical Care, Hospital Universitario de La Princesa, Madrid, Spain

    Alejandro Suárez-de-la-Rica

  2. Spanish Perioperative Audit and Research Network (REDGERM-SPARN), Saragossa, Spain

    Alejandro Suárez-de-la-Rica, Javier Ripollés-Melchor, César Aldecoa, Ane Abad-Motos, Carlos Ferrando & Alfredo Abad-Gurumeta

  3. Department of Anesthesiology and Surgical Critical Care, Hospital Universitario Infanta Leonor, Madrid, Spain

    Javier Ripollés-Melchor, Ane Abad-Motos & Alfredo Abad-Gurumeta

  4. Department of Anesthesiology and Surgical Critical Care, Hospital Universitario Río Hortega, Valladolid, Spain

    César Aldecoa

  5. Department of Anesthesiology and Surgical Critical Care, Hospital Clínic, Barcelona, Spain

    Carlos Ferrando

  6. Department of Biostatistics, Hospital Universitario La Paz, Madrid, Spain

    Mariana Díaz-Almirón

  7. Department of Anesthesiology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain

    Cristina Gil-Lapetra

  8. Department of Anesthesiology, Complejo Asistencial de Segovia, Segovia, Spain

    Francisco Javier García-Miguel

  9. Department of Anesthesiology, Hospital de Igualada, Igualada, Spain

    Ana Pedregosa-Sanz

  10. Department of Anesthesiology and Surgical Critical Care, Hospital Universitario de Son Espases, Palma, Spain

    Neus Esteve-Pérez

  11. Department of Anesthesiology and Surgical Critical Care, Hospital Clínico Valladolid, Valladolid, Spain

    Rita Rodríguez-Jiménez

  12. Department of Anesthesiology, Hospital Nuestra Señora del Prado, Talavera de La Reina, Spain

    Pablo Gimeno Fernandez

  13. Department of Anesthesiology, Hospital Quirónsalud Valle del Henares, Torrejón de Ardoz, Spain

    Emilio Maseda

Authors
  1. Alejandro Suárez-de-la-Rica
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  2. Javier Ripollés-Melchor
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  3. César Aldecoa
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  4. Ane Abad-Motos
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  5. Carlos Ferrando
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  6. Alfredo Abad-Gurumeta
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  7. Mariana Díaz-Almirón
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  8. Cristina Gil-Lapetra
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  9. Francisco Javier García-Miguel
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  10. Ana Pedregosa-Sanz
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  11. Neus Esteve-Pérez
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  12. Rita Rodríguez-Jiménez
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  13. Pablo Gimeno Fernandez
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  14. Emilio Maseda
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Consortia

on behalf of the POWER Study Investigators Group for the Spanish Perioperative Audit and Research Network (RedGERM-SPARN)

  • Cristina Garcia-Perez
  • , Eva Higuera-Míguelez
  • , José M. Marcos-Vidal
  • , María Merino-García
  • , Ana B. Rubio-López
  • , María E. Pascual-Diez
  • , Francisco J. García-Miguel
  • , Luis R. Cabezudo-Sanjose
  • , Ruth Martínez-Díaz
  • , Sara Alegría-Rebollo
  • , José L. González-Rodríguez
  • , María S. Vega-Cruz
  • , Gema Martínez-Ragüés
  • , Manuel A. Gómez-Ríos
  • , Eva Mosquera-Rodríguez
  • , Sara Del-Río-Regueira
  • , José R. Perez-Valdivieso
  • , Marta Martin-Vizcaino
  • , Susana Hernandez-Garcia
  • , Francisco J. Yoldi-Murillo
  • , Miguel Salvador-Bravo
  • , Manuela Rubial-Alvarez
  • , Fabiola Oteiza-Martinez
  • , Enrique Balen-Rivera
  • , José A. Garcia-Erce
  • , Ana Zugasti-Murillo
  • , María E. Petrina-Jáuregui
  • , Domingo Bustos-García
  • , María P. Sánchez-Conde
  • , Antonio Rodríguez-Calvo
  • , María A. Hernández-Valero
  • , María Angoso-Clavijo
  • , Luis M. González-Fernández
  • , Miguel A. Bravo-Riaño
  • , María V. Arnes-Muñoz
  • , Filadelfo Bustos-Molina
  • , Daniel Paz-Martín
  • , Bárbara Vázquez-Vicente
  • , Lourdes González-López
  • , Conrado Mínguez-Marín
  • , Susana Diz-Jueguen
  • , Jaime Seoane-Antelo
  • , Julio Ballinas-Miranda
  • , Ester Carrera-Dacosta
  • , Erica Barreiro-Domínguez
  • , Alexandra Piñeiro-Teijeiro
  • , Raquel Sanchez-Santos
  • , Marina Varela-Duran
  • , Pilar Diaz-Parada
  • , Aránzazu Calero-Lillo
  • , Manuel Ángel López-Lara
  • , Salvador Muñoz-Collado
  • , Juan Valverde-Sintas
  • , Silvia Aznar-Puig
  • , Daniel Troyano-Escribano
  • , Sandra Marmaña-Mezquita
  • , Jesús Fernanz-Antón
  • , Lucia Catot-Alemany
  • , Jaume Balust
  • , Marta Ubré
  • , Carlos Ferrando-Ortolá
  • , Graciela Martínez-Pallí
  • , Ainitze Ibarzabal
  • , Antonio M. Lacy
  • , Rubén Sánchez-Martín
  • , Karina Martins-Cruz
  • , Paula Pérez-Jiménez
  • , Rubén Casans-Francés
  • , Javier Longás
  • , José M. Ramírez Rodríguez
  • , Manuela Elia
  • , Ana Mugarra-Llopis
  • , Cristina Crisan
  • , Estefanía Gracia-Ferrándiz
  • , Esther Romero-Vargas
  • , Marina Soro-Domingo
  • , Rita Rodríguez-Jiménez
  • , Blanca Prada-Martin
  • , Henar Muñoz-Hernández
  • , José I. Gómez Herreras
  • , Sara Cocho-Crespo
  • , Sandra Fernández-Caballero
  • , Miguel Flores-Crespo
  • , Andrea Vázquez-Fernández
  • , Carlo Brugiotti
  • , Estefanía Ollé-Sese
  • , Carla R. Houghton-Acuña
  • , Marta López-Doucil
  • , Ernesto A. Tarazona-López
  • , Iván Bel-Marcobal
  • , Sonia González-Cogollor
  • , Manuel Llácer-Pérez
  • , Alberto Arias-Romano
  • , María C. Arrabal-Taborda
  • , Mercedes Caballero-Domínguez
  • , Rafael García-López
  • , Julio Ontoria-Muriel
  • , Antonio Vivó-Blasco
  • , Enrique Del-Cojo-Peces
  • , Jose M. Tena-Guerrero
  • , Fernando Alcalde Matas
  • , Hernán Giordano
  • , Jose M Perez Peña
  • , Luis Olmedilla-Arnal
  • , Pilar Benito-Saz
  • , Elena López-Gil
  • , Adela Ruiz-Ortega
  • , Sara Zapatero-García
  • , Emilio Del-Valle-García
  • , Víctor Soria-Aledo
  • , Carmen V. Pérez-Guarinos
  • , Enrique Pellicer-Franco
  • , Graciela Valero-Navarro
  • , Mónica Mengual-Ballester
  • , José Andrés García-Marín
  • , Manuel Romero-Simó
  • , Ibán Caravaca-García
  • , Teresa Blasco-Segura
  • , Carlos F. Campo-Betancourth
  • , Rafael David Costa-Navarro
  • , Laura Jordá-Sanz
  • , María I. De-Miguel-Cabrera
  • , José M. España-Pamplona
  • , Silvia Gil-Trujillo
  • , Francisco J. Redondo-Calvo
  • , Víctor Baladrón-Gónzalez
  • , Remedios Moreno-Ballesteros
  • , José L. Muñoz-Rodes
  • , Elena Miranda
  • , Marta Roselló-Chornet
  • , Lourdes Alós-Zaragoza
  • , Juan Catalá-Bauset
  • , María A. Pallardo-López
  • , Noemí Almenara-Almenara
  • , Lorena Muñoz-Devesa
  • , Pablo Gimeno-Fernández
  • , José L. Gómez-Agraz
  • , Carla Iglesias-Morales
  • , Paola B. Ordoñez-Enireb
  • , Ana M. Ríos-Villalba
  • , Joselvy Rodríguez-Pinto
  • , Sergio Sánchez-Cortés
  • , María J. Montoya-Tabares
  • , Vicente Ruiz
  • , Francisco González-Sánchez
  • , Víctor Soriano-Giménez
  • , José M. Muñoz-Camarena
  • , Jorge Benavides-Buleje
  • , Juan C. Estupiñán-Jiménez
  • , Irene Portero-Larragueta
  • , David Alias
  • , Carlos Maristany-Bienert
  • , José A. Pardo-López
  • , Álvaro Ramiro-Ruiz
  • , Pablo García
  • , Arantza Martínez-De-Guereñu
  • , Belinda Montalbán
  • , Claudia Olea
  • , David Benguría
  • , Javier Silva
  • , Adriana Calderón
  • , Jordi Escoll-Rufino
  • , Carlos Cerdan-Santacruz
  • , José E. Sierra-Grañón
  • , María Rufas-Acín
  • , Nuria Mestres-Petit
  • , Ingrid C. Penagos-Saavedra
  • , Cristina Moreno-Castilla
  • , Jordi Riera-Riu
  • , Ana Cuellar-Martínez
  • , R. C. González-Álvarez
  • , Míriam Sánchez-Merchante
  • , Santiago García-Del-Valle-Y-Manzano
  • , Sara García-Zamorano
  • , Natalia Gijón-Herreros
  • , Patricia Robles-Ángel
  • , Enrique Roca-Castillo
  • , María L. Mariscal-Flores
  • , Mario Morales-Cayuela
  • , Irene Alonso-Ramos
  • , Virginia Jiménez-Carneros
  • , Lucas Casalduero-Garcia
  • , Javier Jimenez-Miramón
  • , José L. Ramos-Rodríguez
  • , Ane Abad-Motos
  • , Alfredo Abad-Gurumeta
  • , Norma Aracil-Escoda
  • , Eugenio Martínez-Hurtado
  • , Beatriz Nozal-Mateo
  • , Elena Sáez-Ruiz
  • , Rut Salvachua-Fernández
  • , Javier Ripollés-Melchor
  • , María L. De-Fuenmayor-Valera
  • , Elena Sánchez
  • , Begoña Toribio
  • , Antonio Navarro-Sánchez
  • , José López-Fernández
  • , Dácil Montesdeoca Cabrera
  • , Francisco J. Alcalá-Serrano
  • , María J. Alberola-Estellés
  • , Óscar Díaz-Cambronero
  • , María S. Matoses-Jaén
  • , María D. Ruiz-Boluda
  • , Azahara Sancho-de-Ávila
  • , Sofía Díaz-Carrasco
  • , Almudena Martín-Martín
  • , Alejandro Suárez-de-la-Rica
  • , Rafael Uña-Orejón
  • , Emilio Maseda
  • , Guillermo Tejón-Pérez
  • , María V. Alfaro-Martínez
  • , Marta Alonso-Fernández
  • , María A. Álvarez-Cebrián
  • , María J. Álvarez-Del-Vayo-Rodríguez
  • , Mariana Carrillo-Rivas
  • , María Fernández-Rodríguez
  • , Sonia Trabanco-Morán
  • , José L. Rábago-Morán
  • , Javier Martínez-Ubieto
  • , Ana M. Pascual-Bellosta
  • , Sonia M. Ortega-Lucea
  • , Maria P. Santero-Ramirez
  • , Maria V. Duque-Mallen
  • , Cristian Aragon-Benedi
  • , Andrea Vallejo-Tarrat
  • , Carmen Colillas-Calvet
  • , Maria J. Laso
  • , Javier Martinez-Cabañero
  • , Javier Hernández-Salván
  • , Beatriz Ledesma-Muñoz
  • , Carolina Ochoa-Osorio
  • , Máximo Sanz-García
  • , Begoña Herrero-Garrote
  • , Alma Blázquez-Martin
  • , Manuel Díez-Alonso
  • , Pilar Hernández-Juara
  • , José M. Muguerza-Huguet
  • , Macarena Barbero-Mielgo
  • , Belén San-Antonio-San-Román
  • , Laura Alonso-Aguilar
  • , Viktoria Molnar
  • , María C. Delgado-Naviero
  • , Encarnación Meléndez-Leal
  • , Virginia Cavero-García
  • , África Fernández-Sánchez
  • , Daniela A. Cubek-Quevedo
  • , Rocío Díez Munar
  • , Francisco J. Blázquez-Fernández-De-La Pradilla
  • , A. B. Serrano
  • , A. Balvís
  • , A. Berruezo
  • , E. Esparza
  • , I. De la Hoz
  • , A. Palavicini
  • , L. Pereira
  • , X. Vega
  • , J. Villahoz
  • , G. Villanueva
  • , José I. Alonso-Fernández
  • , César Aldecoa
  • , Clara Bolaño-Pérez
  • , Teresa Villán-González
  • , Astrid Batalla
  • , G. Azparren
  • , M. Basttita
  • , M. Felipe
  • , L. Cueva
  • , Marta Gine
  • , A. M. Gómez-Caro
  • , I. India
  • , S. Piñol
  • , Neus Esteve-Pérez
  • , Carlos Mora-Fernández
  • , Ana Ferrer-Robles
  • , Juan J. Segura–Sampedro
  • , Natalia Alonso-Hernández
  • , Ángels Camps-Cervantes
  • , Ivette Chocrón-Da-Prat
  • , Carolina C. Coronado-Silva
  • , Héctor Duque-Santos
  • , Elena Esclapez-Sempere
  • , Patricia Galan-Menéndez
  • , Silvia Matarín-Olmo
  • , M. P. Tormos-Pérez
  • , Laura Villarino-Villa
  • , Héctor Bergés-Gutiérrez
  • , Miguel Aisa-Gasca
  • , Verónica Arbona-Camillero
  • , José D. Bautista-González
  • , Francisco J. Carballido-Pascual
  • , Mercedes Gutiérrez-Moreno
  • , Ana Muñoz-Durán
  • , Jesús Cañete-Gómez
  • , Esther Cáceres-Fabrega
  • , José M. Lorente-Herce
  • , Octavio Mulet-Zayas
  • , Rocío Gómez-Pérez
  • , Cristina Monje-Salazar
  • , Luis Lobato-Bancalero
  • , Carmelo Torres-Moreno
  • , Elena Sanchez-Cárdenas
  • , Juan J. Daza-González
  • , Teresa Sanchez-Viguera
  • , Antonio Dal-Fresno-Asensio
  • , Laura Bermudez-Román
  • , Rodrigo Sanllorente-Sebastian
  • , Maria C. Villalain-Perez
  • , Mihaela Siclama-Stroe
  • , Judith Benítez-Villar
  • , Alberto Sánchez-Campos
  • , Alberto Martínez-Ruiz
  • , Patricia Alonso-Carnicero
  • , Francisco J. De-La-Torre-González
  • , Carolina Naranjo-Checa
  • , Fernando Pereira-Pérez
  • , Elena Ruiz-Ucar
  • , Alfredo Rivera
  • , Cristina Gil-Lapetra
  • , Eva M. Nogués-Ramia
  • , Yolanda Sosa-Quesada
  • , Alonso Gómez
  • , Laura M. Martínez-Meco-Ortiz
  • , Mercedes Cabellos-Olivares
  • , José R. Rodríguez-Fraile
  • , María Labalde-Martínez
  • , Beatriz Nacarino-Alcorta
  • , Raquel Fernández-García
  • , Borja De-La-Quintana-Gordon
  • , Justyna Drewniak
  • , Fátima Senra-Lorenzana
  • , Pablo Galindo-Jara
  • , Ana B. Gallardo-Herrera
  • , Cesar García-Llorente
  • , Laura Colao-García
  • , Luz-Divina Rellán-Álvarez
  • , Miguel Miro-Murillo
  • , Sahely-Claret Flores-Risco
  • , Jordi Serrat-Puyol
  • , Adrian Medina-Gallardo
  • , Yuhami Mitsahid-Curbelo-Peña
  • , Margarita Logroño-Ejea
  • , José L. Jover-Pinillos
  • , Francisco J. Orts-Micó
  • , Coral Cózar-Lozano
  • , Olga Blasco-Delgado
  • , Andrea Nonnemacher-San-Julián
  • , José A. Pérez
  • , Durán Durán Cruces
  • , Francisco J. Blanco
  • , Aitor Landaluce-Olavarria
  • , Izaskun Badiola
  • , Marta Calvo
  • , Unai De-Andres
  • , Vicente Portugal-Porras
  • , Bakarne Ugarte-Sierra
  • , Ana Pedregosa-Sanz
  • , Laura Perelló-Cerdà
  • , Yobanys Rodríguez-Téllez
  • , Joanna Grössl-Meleán
  • , Xavier Viñas-Truñén
  • , Enrique Alday-Muñoz
  • , Elena Bermejo-Marcos
  • , Pedro A. Alonso-Casado
  • , Francisco A. Gimeno-Calvo
  • , Ana Rodriguez-Sánchez
  • , Carmen Montes-López
  • , Laura Álvarez-Llano
  • , María J. Fas-Vicent
  • , Juan M. Ortega-Monzó
  • , Gustavo Flores-Flores
  • , José L. Tristancho
  • , Sandra Marmaña-Mezquita
  • , Montserrat Bayo-Sans
  • , María C. Deiros-Garcia
  • , Jesús Fernanz-Antón
  • , María L. Gil-Gómez
  • , Lourdes Parra
  • , Vanesa Tejedor-De-La-Fuente
  • , Carlos Jericó-Alba
  • , Núria Borrell Brau
  • , David Camacho-Martín
  • , Jose L. Ortiz-De-Zarate
  • , Daniel López-Ruiz
  • , Vicens Rodriguez-Bustamante
  • , M. Martinez-Vilalta
  • , Daniel Amoros-Ruiz
  • , Marc Sadurni-Sarda
  •  & Pablo Renedo-Corcóstegui

Contributions

A. Suárez-de-la-Rica: project development, data collection, data analysis, and manuscript writing. J. Ripollés-Melchor: project development, data collection, data analysis, and manuscript writing. C. Aldecoa: project development, data collection, data analysis, and manuscript editing. A. Abad-Motos: data collection, data analysis, and manuscript editing. C. Ferrando: data collection, data analysis, and manuscript editing. A. Abad-Gurumeta: data collection, data analysis, and manuscript editing. M. Díaz-Almirón: data analysis and manuscript editing. C. Gil-Lapetra: data collection and manuscript editing. F. García-Miguel: data collection and manuscript editing. A. Pedregosa-Sanz: data collection and manuscript editing. N. Esteve-Pérez: data collection and manuscript editing. R. Rodríguez-Jiménez: data collection and manuscript editing. P. Gimeno Fernandez: data collection and manuscript editing. E. Maseda: project development, data collection, data analysis, and manuscript writing.

Corresponding authors

Correspondence to Alejandro Suárez-de-la-Rica or Emilio Maseda.

Ethics declarations

Ethics Approval

The study was conducted in accordance with the Declaration of Helsinki and approved by The Instituto Aragonés de Ciencias de la Salud Ethics Committee (Zaragoza, Spain) (C.P.-C.I. P117/017) on 1 February 2017.

Informed Consent

Informed consent was obtained from all subjects involved in the study.

Conflict of Interest

Alejandro Suárez-de-la-Rica reports personal fees from Nestlé, MSD, Baxter, Pfizer, and Fresenius Kabi outside the submitted work. Javier Ripollés-Melchor reports personal fees from Edwards Lifesciences, Fresenius Kabi, MSD, Vifor Pharma, and Biomerieux outside the submitted work. Alfredo Abad-Gurumeta reports personal fees from Edwards Lifesciences, MSD, 3 M, Braun, Ferrer, Rovi, and Altan outside the submitted work. Neus Esteve-Pérez reports personal fees from Grünenthal and MSD outside the submitted work. No other disclosures were reported. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

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Suárez-de-la-Rica, A., Ripollés-Melchor, J., Aldecoa, C. et al. Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery: Secondary Analysis Of POWER Trial. J Gastrointest Surg 27, 2187–2198 (2023). https://doi.org/10.1007/s11605-023-05780-z

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