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. 2018 Aug;46(4):283-291.
doi: 10.5152/TJAR.2018.92244. Epub 2018 May 2.

Risk Factors for Prolonged Intensive Care Unit Stay After Open Heart Surgery in Adults

Muzaffer Tunç  1 , Cengiz Şahutoğlu  1 , Nursen Karaca  1 , Seden Kocabaş  1 , Fatma Zekiye Aşkar  1
Affiliations

Risk Factors for Prolonged Intensive Care Unit Stay After Open Heart Surgery in Adults

Muzaffer Tunç et al. Turk J Anaesthesiol Reanim. 2018 Aug.

Abstract

Objective: Prolonged intensive care unit (ICU) stay prevents the use of ICU equipment by other patients and increases hospital cost. This retrospective study aimed to investigate the risk factors for prolonged ICU stay in patients undergoing open heart surgery.

Methods: The medical records of 513 patients who underwent coronary artery bypass grafting and valvular heart surgery were retrospectively evaluated. Patients were divided into two groups based on their ICU stay: groups I (<48 h) and II (≥48 h). The effect of patient variables on the ICU stay duration was investigated using logistic regression analysis.

Results: The mean age of the patients was 61.5±10 years, and 69% were males. The ICU stay of ≥48 h was observed in 20.1% of the patients. Diabetes mellitus and low ejection fraction (pre-operative variables); long aortic cross clamp, cardiopulmonary bypass time and intra-aortic balloon pump requirement (intra-operative variables); arrhythmia, myocardial infarction, renal dysfunction and need for haemodialysis, use of ≥2 inotropic agents, infection, sepsis and respiratory complication (post-operative variables) were found to prolong the ICU stay. In multivariate logistic regression analysis, intra-aortic balloon pump requirement, use of ≥2 inotropic agents, post-operative myocardial infarction and need for haemodialysis were found to be independent risk factors for prolonged ICU stay (p<0.05). Early mortality was 0.97% (5 patients).

Conclusion: Intra-aortic balloon pump requirement, use of ≥2 inotropic agents, post-operative myocardial infarction and need for post-operative haemodialysis are independent risk factors for patients undergoing open heart surgery. Selection of methods for protecting the myocardium and renal functions during the intra-operative period would reduce the duration of ICU stay.

Keywords: Cardiac surgery; cardiopulmonary bypass; intensive care; post-operative complications; risk factors.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

References

    1. Ferguson TB, Hammill BG, Peterson ED, DeLong ER, Grover FL STS National database committee. A decade of change risk profiles and outcomes for isolated coronary artery bypass grafting procedures, 1990–1999 a report from the STS National Database Committee and the Duke Clinical Research Institute. Society of Thoracic Surgeons Ann Thorac Surg. 2002;73:480–9. - PubMed
    1. Van Mastrigt GA, Heijmans J, Severens JL, Fransen EJ, Roekaerts P, Voss G, et al. Short stay intensive care after coronary artery bypass surgery: randomized clinical trial on safety and cost effectiveness. Crit Care Med. 2006;34:65–75. doi: 10.1097/01.CCM.0000191266.72652.FA. - DOI - PubMed
    1. Bucerius J, Gummert JF, Walther T, Doll N, Falk V, Schmitt DV, et al. Predictors of prolonged ICU stay after on-pump versus off pump coronary artery bypass grafting. Intensive Care Med. 2004;30:88–95. doi: 10.1007/s00134-003-1950-5. - DOI - PubMed
    1. Heimrath OP, Buth KJ, Légaré JF. Long-term outcomes in patients requiring stay of more than 48 hours in the intensive care unit following coronary bypass surgery. J Crit Care. 2007;22:153–8. doi: 10.1016/j.jcrc.2006.09.009. - DOI - PubMed
    1. Hein OV, Birnbaum J, Wernecke K, England M, Konertz W, Spies C. Prolonged intensive care unit stay in cardiac surgery: risk factors and long-term-survival. Ann Thorac Surg. 2006;81:880–5. doi: 10.1016/j.athoracsur.2005.09.077. - DOI - PubMed

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