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Published on: March 27, 2018
Risk factors for prolonged hospital stay after isolated coronary artery bypass grafting
Insights
Diabetes and smoking predict longer intensive care unit stays after coronary artery bypass grafting. Infection and mechanical ventilation also increase hospitalization duration, impacting patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Health Services Research
Background:
- Patient and procedure characteristics can lead to prolonged hospital stays after coronary artery bypass grafting (CABG).
- Extended hospitalization increases healthcare costs, morbidity, and mortality.
- Identifying risk factors is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To evaluate individual and perioperative risk factors associated with prolonged intensive care unit (ICU) and ward hospitalizations.
- To identify predictors of extended stays following isolated CABG with cardiopulmonary bypass.
Main Methods:
- A case-control study involving 104 patients undergoing isolated CABG with cardiopulmonary bypass.
- Prolonged ICU stay defined as >3 days; prolonged ward stay defined as >7 days.
- Statistical analysis included chi-square tests, odds ratios, and logistic regression (P <0.05 significance).
Main Results:
- 22.1% of patients had prolonged ICU stays (>3 days); 27.9% had prolonged ward stays (>7 days).
- Preoperative diabetes (OR=3.17) and smoking (OR=4.07) predicted prolonged ICU stays.
- Mechanical ventilation >24 hours (OR=6.10) predicted ICU outcome; left ventricular ejection fraction <50% (OR=3.04) predicted ward outcome.
- Postoperative infection (OR=4.54) predicted prolonged ward hospitalization.
Conclusions:
- Diabetes and smoking are key predictors of prolonged ICU stays post-CABG.
- Reduced ejection fraction predicts prolonged ward stays.
- Mechanical ventilation and infection are significant perioperative factors contributing to extended hospitalizations after CABG.
Introduction:
Characteristics of the patient and the coronary artery bypass grafting may predispose individuals to prolonged hospitalization, increasing costs and morbidity and mortality.
Objective:
The objective of this study was to evaluate individual and perioperative risk factors of prolonged hospitalization in intensive care units and wards.
Methods:
We conducted a case-control study of 104 patients undergoing isolated coronary artery bypass grafting with cardiopulmonary bypass. Patients hospitalized >3 days in the intensive care unit or >7 days in the ward were considered for the study. The association between variables was estimated by the chi-square test, odds ratio and logistic regression; P <0.05 was considered statistically significant.
Results:
Hospital stay >3 days in the intensive care unit occurred for 22.1% of patients and >7 days in the ward for 27.9%. Among preoperative factors, diabetes (OR=3.17) and smoking (OR=4.07) were predictors of prolonged intensive care unit stay. Combining the pre-, intra-and postoperative variables, only mechanical ventilation for more than 24 hours (OR=6.10) was predictive of intensive care unit outcome. For the ward outcome, the preoperative predictor was left ventricular ejection fraction <50% (OR=3.04). Combining pre- and intraoperative factors, diabetes (OR=2.81), and including postoperative factors, presence of infection (OR=4.54) were predictors of prolonged hospitalization in the ward.
Conclusion:
Diabetes and smoking were predictors of intensive care unit outcome, and ejection fraction <50% of ward outcome. For the set of perioperative factors, prolonged hospitalization after isolated coronary artery bypass grafting was associated with mechanical ventilation >24 hours for the intensive care unit and presence of infection for the ward.
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