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Risk factors for prolonged intensive care unit stays in patients after cardiac surgery with cardiopulmonary bypass: A
Xueying Zhang1, Wenxia Zhang2, Hongyu Lou3
1School of Nursing, Sun Yat-Sen University, Guangzhou, China.
Insights
A significant number of patients experience prolonged intensive care unit (ICU) stays after cardiac surgery with cardiopulmonary bypass (CPB). Key risk factors include longer CPB duration and postoperative complications like arrhythmias.
Area of Science:
- Cardiology
- Critical Care Medicine
- Surgical Outcomes
Background:
- Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) typically require intensive care unit (ICU) admission.
- Understanding the factors influencing the length of stay (LOS) in the ICU is crucial for resource management and patient care optimization.
Purpose of the Study:
- To determine the incidence of prolonged ICU length of stay (LOS) in patients following cardiac surgery with CPB.
- To identify clinical and intraoperative risk factors associated with extended ICU stays.
Main Methods:
- An observational, retrospective study was conducted on 395 patients who underwent cardiac surgery with CPB.
- Data were collected from a hospital database, and binary logistic regression was employed to analyze risk factors for prolonged ICU LOS.
Main Results:
- The incidence of prolonged ICU LOS (>72 hours) was 34.7% (137 patients), with a median ICU LOS of 50.9 hours.
- Significant risk factors for prolonged ICU LOS included duration of CPB, prolonged mechanical ventilation, low PaO2/FiO2 ratios post-surgery, type of surgery, red blood cell infusion, and postoperative arrhythmias.
Conclusions:
- The study identified several key predictors of prolonged ICU LOS after cardiac surgery with CPB.
- These findings can aid clinicians in early identification of at-risk patients, facilitating timely interventions to improve recovery trajectories.
Objectives:
Patients after cardiac surgery with cardiopulmonary bypass (CPB) require a stay in the ICU postoperatively. This study aimed to investigate the incidence of prolonged length of stay (LOS) in the ICU after cardiac surgery with CPB and identify associated risk factors.
Methods:
The current investigation was an observational, retrospective study that included 395 ICU patients who underwent cardiac surgery with CPB at a tertiary hospital in Guangzhou from June 2015 to June 2017. Data were obtained from the hospital database. Binary logistic regression modeling was used to analyze risk factors for prolonged ICU LOS.
Results:
Of 395 patients, 137 (34.7%) had a prolonged ICU LOS (>72.0 h), and the median ICU LOS was 50.9 h. Several variables were found associated with prolonged ICU LOS: duration of CPB, prolonged mechanical ventilation and non-invasive assisted ventilation use, PaO2/FiO2 ratios within 6 h after surgery, type of surgery, red blood cell infusion during surgery, postoperative atrial arrhythmia, postoperative ventricular arrhythmia (all P < 0.05).
Conclusions:
These findings are clinically relevant for identifying patients with an estimated prolonged ICU LOS, enabling clinicians to facilitate earlier intervention to reduce the risk and prevent resulting delayed recovery.
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