Evaluation of the effectiveness of risk scores and blood values in predicting the need for postoperative intensive care

Postoperative intensive care unit (ICU) requirement is an important clinical parameter that directly affects mortality and morbidity. Surgical stress, duration of anesthesia, comorbidities, and intraoperative complications are the main factors determining the need for ICU admission. However, reliable biomarkers and scoring systems that can predict this requirement in advance are still being investigated. The aim of this study was to evaluate clinical (ASA, SORT, and CACI scores) and hematological (NLR, PLR, MPV) parameters that may be used to predict postoperative ICU requirement and to determine their predictive values. In this prospective, single-center study, 995 adult patients who underwent surgery in various surgical departments were analyzed. Demographic data, type of surgery (emergency/elective), presence of malignancy, type of anesthesia, and preoperative hematological parameters were recorded. ASA, SORT, and CACI scores were calculated for each patient, and the data were statistically analyzed using logistic regression and ROC analysis. Postoperative ICU requirement developed in 16.3% of the patients. ASA, CACI, and SORT scores, as well as age, gender, presence of malignancy, and emergency surgery, were significantly associated with ICU requirement (p<0.05). The most powerful predictive variable was the ASA score; each one-point increase raised the likelihood of ICU admission by 4.4 times. It was determined that ASA, CACI, and SORT scores are reliable tools for predicting postoperative ICU requirement and that hemoglobin levels, when evaluated together with these scores, strengthen risk stratification. Routine preoperative assessment of these parameters may contribute to early identification of high-risk patients and the establishment of appropriate postoperative monitoring plans.