Predictors of Length of Stay in Intensive Care Unit after Coronary Artery Bypass Grafting: Development a Risk Scoring System

Abstract

Introduction To determine predictors of length of stay (LOS) in the intensive care unit (ICU) after coronary artery bypass grafting (CABG) and to develop a risk scoring system were the objectives of this study. Methods In this retrospective study, 1202 patients' medical records after CABG were evaluated by a research-made checklist. Tarone-Ware test was used to determine the predictors of patients' LOS in the ICU. Cox regression model was used to determine the risk factors and risk ratios associated with ICU LOS. Results The mean ICU LOS after CABG was 55.27±17.33 hours. Cox regression model showed that having more than two chest tubes (95% confidence interval [CI] 1.005-1.287, Relative Risk [RR]=1.138), occurrence of atelectasis (95% CI 1.000-3.007, RR=1.734), and occurrence of atrial fibrillation after CABG (95% CI 1.428-2.424, RR=1.861) were risk factors associated with longer ICU LOS. The discrimination power of this set of predictors was demonstrated with an area under the receiver operating characteristic curve and it was 0.69. A simple risk scoring system was developed based on three identified predictors that can raise ICU LOS. Conclusion The simple risk scoring system developed based on three identified predictors can help to plan more accurately a patient's LOS in hospital for CABG and can be useful in managing human and financial resources.

Predicting Intensive Care Unit Length of Stay After Acute Type A Aortic Dissection Surgery Using Machine Learning

“…The selection of the patients determines the applicability of the models constructed in the respective studies. Although there were models to predict ICU-LOS ( 6 , 9 , 18 , 19 ), most of them focused on cardiac surgical patients and thus may not be suitable for aortic dissection surgical patients. The logistic regression was the most common model, with AUCs ranging from 0.60 to 0.84.…”

Perceived stress level of the postoperative coronary artery bypass graft patients in the intensive care unit

“…[1] Annually in the United States (US), about 18 million Americans are diagnosed with coronary artery disease (CAD), in fact, it is estimated that about one-third of all deaths is due to CAD. [2,3] Although CABG surgery contributes to an overall improvement in the quality of life for many individuals, the surgery itself can be a significant stressor. [4,5] Although CABG is a vital surgical treatment, it is considered by many CABG patients as life threatening and stressful which can invoke fear and anxiety in many patients and their families.…”

“…[6,7] All post CABG surgical patients will spend at least 24 hours in the intensive care unit (ICU) due to having many short and long-term complications despite the beneficial effects of surgery in controlling the signs and symptoms of coronary artery disease. [3] The ICU environment is known to be stressful with physical and psychological factors that affect patients. [8] The presence of strange machinery, disturbing alarms, high noise levels, bright lights, invasive procedures, cardiac monitoring, fear of pain and discomfort, sleep disturbances, and constant interruptions of nursing care contributes to making the ICU a stressful environment.…”

Scoring Systems Estimating Length of Stay in Intensive Care Unit Before Coronary Artery Bypass Grafting

“…We interestingly read the article by Zarrizi et al [ 1 ] entitled “Predictors of Length of Stay in Intensive Care Unit after Coronary Artery Bypass Grafting”. First, I congratulate the authors for their invaluable contribution to the literature.…”