Predictors of Prolonged Stay in the Intensive Care Unit following Cardiac Surgery

Abstract

The prediction of intensive care unit length of stay (ICU-LOS) could contribute to more efficient ICU resources' allocation and better planning of care among cardiac surgery patients. The aim of this study was to identify the preoperative and intraoperative predictors for prolonged cardiac surgery ICU-LOS. An observational cohort study was conducted among 150 consecutive patients, who were admitted to the cardiac surgery ICU of a tertiary hospital of Athens, Greece from September 2010 to January 2011. Multivariate regression analysis revealed that patients with increased creatinine levels preoperatively (odds ratio (OR) 3.0, P = 0.049), history of atrial fibrillation (AF) (OR 6.3, P = 0.012) and high EuroSCORE values (OR 2.6, P = 0.017) had a significant greater probability to stay in the ICU for more than 2 days. In addition, intraoperative hyperglycemia (OR 3.0, P = 0.004) was strongly associated with longer ICU-LOS. In conclusion, the high perioperative risk, the history of AF and renal dysfunction, and the intraoperative hyperglycemia are significant predictors of prolonged ICU stay. The early identification of patients at risk could allow the efficient ICU resources' allocation and the reduction of healthcare costs. This would contribute to nursing care planning depending on the availability of healthcare personnel and ICU bed capacity.

Acute risk change (ARC) identifies outlier institutions in perioperative cardiac surgical care when the standardized mortality ratio cannot

“…Our population had a similar ICU length of stay to other studies in Australia, 31 but the length of stay was longer than seen in some other countries. [32][33][34][35] Although 'AusSCORE' is not collected in countries other than Australia, many use analogous scores (e.g. EuroSCORE).…”

A Pragmatic Preoperative Prediction Score for Nonhome Discharge After Cardiac Operations

“…The patient's preoperative physical and social characteristics, including age, sex, type of operation, comorbidities, prior level of function, social support, nutritional status, body mass index, and postoperative complications, affect discharge planning [2,[6][7][8][9]. After a cardiac operation, models to predict intensive care unit stay and NHD after hospitalization have been developed based on preoperative variables and overall medical status [2,6,[9][10][11]. This previous research has emphasized postoperative factors and length of stay as primary drivers of discharge destination.…”

Factors of Prolonged Intensive Care Unit Stay After Surgery in Patients with Type A Acute Aortic Dissection

“…Studies have shown that routine postoperative ICU monitoring and the time of stay depends on factors such as re-exploration or re-operation, emergency surgery, age, increased pre-operative creatinine levels, left ventricular dysfunction, duration of cardiopulmonary bypass, and blood transfusion etc. [20][21][22][23][24].…”