Algengi og áhættuþættir lengdrar dvalar á gjörgæsludeild eftir kransæðahjáveituaðgerð
Open Access
- 5 March 2020
- journal article
- research article
- Published by Laeknabladid/The Icelandic Medical Journal in Læknablaðið
- Vol. 2020 (03), 123-129
- https://doi.org/10.17992/lbl.2020.03.471
Abstract
Introduction: To maximize the use of intensive care unit (ICU) resources, it is important to estimate the prevalence and risk factors for prolonged ICU unit stay after coronary artery bypass grafting (CABG) surgery. Material and methods: This retrospective cohort study included all patients who underwent primary isolated CABG at Landspitali between 2001 and 2018. Patient information was collected from hospital charts and death registries. Patients who stayed in the ICU for the conventional one night postoperatively were compared with those who needed longer stays in the ICU. Survival rate was estimated with the Kaplan-Meier method. Predictors for prolonged ICU stay were calculated with logistic regression and the outcome used to create a calculator that estimates the probability of prolonged ICU stay. Results: Out of 2177 patients, 20% required prolonged ICU stay. Patients with prolonged stay were more frequently female (23% vs 16%, p=0.001), had a higher rate of cardiovascular risk factors and higher EuroSCORE 11 (4.7 vs. 1.9, p<0.001). They also had a higher rate of impaired renal function before surgery (14% vs. 4%, p<0.001) and emergent surgery (18% vs. 2%, p<0.001). Furthermore, these patients had higher rates of both short-term and long-term complications, and lower long-term survival (85% vs 68% five-year survival rate, p<0.0001). Independent risk factors for prolonged ICU stay were advanced age, female gender, EuroSCORE II. history of heart diseases, impaired renal function and emergent surgery. Conclusions: Every fifth patient had a prolonged ICU stay after CABG. Several risk factors predicted prolonged ICU stay after CABG, in particular patients' medical condition before surgery, EuroSCORE II and emergent surgery. A better understanding of the risk factors for prolonged ICU stay will hopefully aid in scheduling CABG surgeries at Landspitali.Keywords
This publication has 11 references indexed in Scilit:
- Tólf gjörgæslurúm á Landspítala - dugar það til?Læknablaðið, 2018
- The influence of prolonged intensive care stay on quality of life, recovery, and clinical outcomes following cardiac surgery: A prospective cohort studyThe Journal of Thoracic and Cardiovascular Surgery, 2018
- Outcomes of Patients With Prolonged Intensive Care Unit Length of Stay After Cardiac SurgeryJournal of Cardiothoracic and Vascular Anesthesia, 2016
- Long-term treated intensive care patients outcomes: the one-year mortality rate, quality of life, health care use and long-term complications as reported by general practitionersBMC Anesthesiology, 2015
- Prediction Models for Prolonged Intensive Care Unit Stay After Cardiac SurgeryCell Metabolism, 2010
- Effect of length of stay in intensive care unit on hospital and long-term mortality of critically ill adult patientsBritish Journal of Anaesthesia, 2010
- Predicting prolonged intensive care unit length of stay in patients undergoing coronary artery bypass surgery - development of an entirely preoperative scorecardInteractive CardioVascular and Thoracic Surgery, 2009
- Predictive value of EuroSCORE on long term outcome in cardiac surgery patients: a single institution studyHeart, 2005
- Early discharge after coronary artery bypass graft surgery: Are patients really going home earlier?The Journal of Thoracic and Cardiovascular Surgery, 2001
- Outcome of long-stay intensive care patientsIntensive Care Medicine, 2001