Intensive and high-dependency care for the high-risk surgical patient

Mortality following surgery has decreased enormously since the introduction of anaesthesia. It has long been recognized that post-operative patients benefit from special attention immediately following surgery and that recovery rooms are essential for the management of these patients. Nonetheless some 20000 patients die after surgery each year in the United Kingdom. Most, but not all, can be identified as high risk before surgery. Intraoperative mortality is low and the post-operative period is probably where the patients are most at risk. Tightly controlling physiological values and providing additional support during this period may avoid preventable deaths. Access to critical care facilities is important to achieve this. The United Kingdom has relatively limited provision of intensive care and high-dependency care.