BACKGROUND: Risk factors have been found for prolonged intensive care unit (ICU) stay in cardiac surgery patients in only a few studies; conflicting results have been described. The focus of this study was twofold: first, to evaluate preoperative, intraoperative, and postoperative risk factors for ICU stay greater than 3 days in a cardiac surgery patient population; second, to evaluate long-term survival in cardiac surgery patients with prolonged ICU stay. METHODS: Records from 2,683 cardiac surgery patients were retrospectively evaluated. Univariate and multivariate analyses for risk factors were performed for an ICU stay greater than 3 days. Thereafter, 2,563 patients were enrolled in a follow-up study for an observational time of 3 years after surgery. RESULTS: Mortality was dependent on renal, respiratory, and heart failure, as well as age, elevated APACHE II scores, and reexploration. Long-term survival analyses demonstrated a significantly lower survival in patients with longer ICU stay. However, the 6-month to 3-year long-term survival was comparable with survival in patients without prolonged ICU stay. CONCLUSIONS: Because of the increasing acuity of patients needing cardiac surgery, it is important to identify those at risk for a prolonged ICU course. It is therefore of paramount interest to implement measures throughout their entire hospital stay that would maximize organ function to improve survival and resource utilization.
BACKGROUND: Risk factors have been found for prolonged intensive care unit (ICU) stay in cardiac surgery patients in only a few studies; conflicting results have been described. The focus of this study was twofold: first, to evaluate preoperative, intraoperative, and postoperative risk factors for ICU stay greater than 3 days in a cardiac surgery patient population; second, to evaluate long-term survival in cardiac surgery patients with prolonged ICU stay. METHODS: Records from 2,683 cardiac surgery patients were retrospectively evaluated. Univariate and multivariate analyses for risk factors were performed for an ICU stay greater than 3 days. Thereafter, 2,563 patients were enrolled in a follow-up study for an observational time of 3 years after surgery. RESULTS: Mortality was dependent on renal, respiratory, and heart failure, as well as age, elevated APACHE II scores, and reexploration. Long-term survival analyses demonstrated a significantly lower survival in patients with longer ICU stay. However, the 6-month to 3-year long-term survival was comparable with survival in patients without prolonged ICU stay. CONCLUSIONS: Because of the increasing acuity of patients needing cardiac surgery, it is important to identify those at risk for a prolonged ICU course. It is therefore of paramount interest to implement measures throughout their entire hospital stay that would maximize organ function to improve survival and resource utilization.
Authors: Manfred Otto Vogt; Jürgen Hörer; Sophie Grünewald; Daniela Otto; Harald Kaemmerer; Christian Schreiber; John Hess Journal: Pediatr Cardiol Date: 2011-09-08 Impact factor: 1.655
Authors: Chih-Wen Cheng; Nikhil Chanani; Janani Venugopalan; Kevin Maher; May Dongmei Wang Journal: IEEE J Transl Eng Health Med Date: 2013-11-21 Impact factor: 3.316
Authors: J Schöttler; A Hagemann; C Grothusen; S Stohn; D Pleger; M von der Brelie; J Cremer; N Haake Journal: Med Klin Intensivmed Notfmed Date: 2011-10-07 Impact factor: 0.840
Authors: Jonathan L Hatch; Michael J Bauschard; Shaun A Nguyen; Paul R Lambert; Ted A Meyer; Theodore R McRackan Journal: Otolaryngol Head Neck Surg Date: 2018-03-27 Impact factor: 3.497
Authors: Christina Grothusen; Tim Attmann; Christine Friedrich; Sandra Freitag-Wolf; Nils Haake; Jochen Cremer; Jan Schöttler Journal: Interv Med Appl Sci Date: 2013-03-19