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Title	Claps	Level	Year	L/Y
Mortality and utilisation of critical care resources amongst high‐risk surgical patients in a large NHS trust * S. Jhanji, BP Thomas, A. Ely, D. Watson, C. Hinds, R. Pearse Previous reports describe a population of non‐cardiac surgical patients at high risk of complications and death. Outcomes are sub‐optimal for such patients, perhaps in part related to inadequate provision or ineffective utilisation of critical care … Previous reports describe a population of non‐cardiac surgical patients at high risk of complications and death. Outcomes are sub‐optimal for such patients, perhaps in part related to inadequate provision or ineffective utilisation of critical care resources. In this study, data describing 26 051 in‐patient non‐cardiac surgical procedures performed in a large NHS Trust between April 2002 and March 2005 were extracted from local databases. Of these procedures, 2 414 (9.3%) were high risk with an overall mortality rate of 12.2% and a prolonged hospital stay (high‐risk population median (IQR) 16 (9–30) days vs standard risk 3 (2–6) days). Mortality rates for specific procedures were consistent with UK averages. However, only 852 (35.3%) high‐risk patients were admitted to a critical care unit at any stage after surgery. Of 294 high‐risk patients who died, only 144 (49.0%) were admitted to a critical care unit at any time and only 75 (25.6%) of these deaths occurred within a critical care area. Mortality rates were high amongst patients discharged and readmitted to critical care (37.7%) and amongst those admitted to critical care following initial postoperative care on a standard ward (29.9%). These data suggest that the outcome of high‐risk general surgical patients could be improved by adequate provision and more effective utilisation of critical care resources. Published in Anaesthesia	277	7	2008