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Research Snapshot Theater: Administration, Adult

Elective ICU Booking and Utilization for Postoperative Patients: A Five-Year Retrospective Review

Sunday, March 22, 2026
9:45 AM - 10:45 AM Central Time
Location: Connections Central - RST 01
Introduction: Planned postoperative ICU utilization can improve perioperative outcomes, yet preoperative requests for ICU admission are often based on subjective judgment. Limited ICU bed availability may delay or cancel high-risk elective procedures. This study assessed the number of preoperative ICU requests generated for elective surgery and their actual postoperative utilization.


Methods: This retrospective review included all adult patients undergoing elective surgical procedures, excluding cardiothoracic and obstetric cases, from January 2019 to December 2023 at a tertiary hospital. Emergency or urgent cases and patients with incomplete records were excluded. Data included requesting specialty, surgical type, and postoperative ICU utilization.

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Results: Over the study period, 1,104 postoperative ICU requests were made; only 255 (23.09%) resulted in ICU admission. Neurosurgery generated the highest number of requests (n=402), with craniotomy being the most frequently cited procedure. Urology had the worst ICU bed utilization, with only 10.6% of ICU requests resulting in actual post-operative ICU admissions (13 out of 123 requests). The low ICU utilization in Urology likely reflects over-triaging of elderly patients with comorbidities. Maxillofacial Surgery, Ophthalmology, and Plastic Surgery showed the highest ICU utilization rates, likely due to low case volumes, selective ICU requests, and clear surgical indications necessitating postoperative monitoring.


Conclusions: Postoperative ICU bookings exceeded actual utilization, with marked variation between specialties. Incorporating objective risk stratification tools such as the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator into preoperative planning may improve booking efficiency, particularly for cardiac risk assessment. For procedures where non-cardiac complications predominate, specialty-specific risk models and multidisciplinary review could further optimize ICU allocation and reduce unnecessary bookings.