Are duration of mechanical ventilation and cardiopulmonary bypass or aortic cross-clamp times correlated with hospital length of stay?

Cislaghi, F.; Munari, M.; Corona, Alberto; Condemi, A. M.

doi:10.1097/00003643-200706003-00102

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“…29 Moreover, longer aortic cross-clamp time is also associated with longer hospital length of stay in cardiac surgery. 40,41 On multivariable analysis, ventricular septal defect repair (Category 2) was associated with a lower likelihood of prolonged length of stay. This is consistent with previous studies that show that a higher Risk Adjustment for Congenital Heart Surgery-1 category is associated with longer length of ICU 42 and hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Prolonged length of stay after surgery for adult congenital heart disease: a single-centre study in a developing country

et al. 2020

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Background: With the growing number of adults requiring operations for CHD, prolonged length of stay adds an additional burden on healthcare systems, especially in developing countries. This study aimed to identify factors associated with prolonged length of stay in adult patients undergoing operations for CHD. Methods: This retrospective study included all adult patients (≥18 years) who underwent cardiac surgery with cardiopulmonary bypass for their CHD from 2011 to 2016 at a tertiary-care private hospital in Pakistan. Prolonged length of stay was defined as hospital stay >75th percentile of the overall cohort (>8 days). Results: This study included 166 patients (53.6% males) with a mean age of 32.05 ± 12.11 years. Comorbid disease was present in 59.0% of patients. Most patients underwent atrial septal defect repair (42.2%). A total of 38 (22.9%) patients had a prolonged length of stay. Post-operative complications occurred in 38.6% of patients. Multivariable analysis showed that pre-operative body mass index (odds ratio: 0.779; 95% confidence interval: 0.620–0.980), intraoperative aortic cross-clamp time (odds ratio: 1.035; 95% confidence interval: 1.009–1.062), and post-operative acute kidney injury (odds ratio: 7.392; 95% confidence interval: 1.036–52.755) were associated with prolonged length of stay. Conclusion: Predictors of prolonged length of stay include lower body mass index, longer aortic cross-clamp time, and development of post-operative acute kidney injury. Shorter operations, improved pre-operative nutritional optimisation, and timely management of post-operative complications could help prevent prolonged length of stay in patients undergoing operations for adult CHD.

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