Introduction/Background The purpose of the study was to ascertain patient characteristics and perioperative factors associated with prolonged admission to the Intensive Care Unit (ICU) following cytoreductive surgery for ovarian cancer.

Methodology A retrospective review of patients admitted to the ICU after surgery for ovarian cancer in a single tertiary center from 2004–2023 was conducted. Patients were separated into two groups, depending on the length of ICU stay, Group A: < 48-hours (n=47 (63.5%) ), Group B: > 48-hours (n=27 (36.5%) ). Preoperative patient characteristics (age, BMI, ASA classification) and intraoperative characteristics (ascites, pleura effusion, blood loss, operation duration, bowel resection, complications, epidural anesthesia, body temperature at the end of the operation) were compared across the two groups by univariate and multivariate logistic regression analysis.

Results A total of 74 women were admitted to the ICU. Sixty eight patients (91.9%) required vital support and fluid management, five patients (6.8%) required support due to hemodynamic instability and one patient (1.3%) due to respiratory status. All preoperative variables were similar between two groups, except from BMI which was associated with increased risk for admission to the ICU for > 48h (OR 1.14, 95% CI 1.02–1.28, p=0.027). ιntraoperative blood loss was significantly different between the two groups (p=0.017). Prolonged surgery duration (OR 1.01, 95% CI 1.00–1.02, p=0.021) was associated with extended ICU stay. The use of epidural anesthesia decreased the likelihood of prolonged ICU stay (OR 0.96, 95% CI 0.2–4.51, p=0.957), as well as higher body temperature at the end of the operation (OR 0.22, 95% CI 0.07 -0.72, p=0.012).

Conclusion Specific perioperative criteria can predict whether a patient with ovarian cancer may require a prolonged ICU stay. These findings facilitate appropriate preoperative counseling and empower gynecologic-oncologists to identify these patients, that will benefit most from postoperative ICU admission, contributing to improved resource management in favor of patients.

Disclosures The data analysis of this retrospective study has shown that, apart from factors that lead to extended ICU utilization such as increased BMI, prolonged surgery duration, and increased intraoperative blood loss, there are two additional factors that can decrease this likelihood: the use of epidural anesthesia and a higher body temperature at the end of the operation.