Independent Predictors of Postoperative ICU Admission after Otorhinolaryngologic Surgery: A Retrospective Cohort Study

Objective: To determine the incidence of postoperative intensive care unit (ICU) admission and to identify factors associated with ICU admission after otorhinolaryngologic surgery.Methods: This single-centre retrospective cohort study included patients who underwent otorhinolaryngologic surgery between 1 July 2025, and 31 December 2025. Demographic, clinical, and perioperative data were obtained from the hospital record system. Postoperative ICU admission was evaluated in relation to age, operative duration, cardiac comorbidity, and pulmonary disease using multivariable logistic regression analysis.Results: A total of 633 patients were included, and 36 (5.7%) required postoperative ICU admission. In the adjusted analysis, age ≥65 years, operative duration ≥3 hours, and pulmonary disease were independently associated with postoperative ICU admission. Age ≥65 years was associated with a markedly increased risk of ICU admission (adjusted odds ratio [aOR] 10.3, 95% confidence interval [CI] 3.1-35.1; p<0.001). Operative duration ≥3 hours was also independently associated with ICU admission (aOR 5.26, 95% CI 1.91-14.54; p=0.001), as was pulmonary disease (aOR 8.57, 95% CI 2.31-31.83; p=0.001). Cardiac comorbidity showed a borderline association (aOR 5.88, 95% CI 0.93-37.02; p=0.059).Conclusion: Postoperative ICU admission after otorhinolaryngologic surgery was independently associated with advanced age, prolonged operative duration, and pulmonary disease. These findings may support perioperative risk stratification and postoperative care planning in patients undergoing otorhinolaryngologic surgery.