• Vijay Krishnamoorthy, Tetsu Ohnuma, Raquel Bartz, Matthew Fuller, Nita Khandelwal, Krista Haines, Charles Scales, and Karthik Raghunathan.
• Vijay Krishnamoorthy is associate professor in the Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Division of Critical Care Medicine, and in the Department of Population Health Sciences, Duke University, Durham, North Carolina.
• Am. J. Crit. Care. 2021 Jul 1; 30 (4): 320-324.

BackgroundThe COVID-19 pandemic created pressure to delay inpatient elective surgery to increase US health care capacity. This study examined the extent to which common inpatient elective operations consume acute care resources.MethodsThis cross-sectional study used the Premier Healthcare Database to examine the distribution of inpatient elective operations in the United States from the fourth quarter of 2015 through the second quarter of 2018. Primary outcomes were measures of acute care use after 4 common elective operations: joint replacement, spinal fusion, bariatric surgery, and coronary artery bypass grafting. A framework for matching changing demand with changes in supply was created by overlaying acute care data with publicly available outbreak capacity data.ResultsElective coronary artery bypass grafting (n = 117 423) had the highest acute care use: 92.8% of patients used intensive care unit beds, 89.1% required postoperative mechanical ventilation, 41.0% required red blood cell transfusions, and 13.3% were readmitted within 90 days of surgery. Acute care use was also substantial after spinal fusion (n = 203 789): 8.3% of patients used intensive care unit beds, 2.2% required postoperative mechanical ventilation, 9.2% required red blood cell transfusions, and 9.3% were readmitted within 90 days of surgery. An example of a framework for matching hospital demand with elective surgery supply is provided.ConclusionsAcute care needs after elective surgery in the United States are consistent and predictable. When these data are overlaid with national hospital capacity models, rational decisions regarding matching supply to demand can be achieved to meet changing needs.© 2021 American Association of Critical-Care Nurses.

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