M Meziane1, A Koundi2, A Meskine2, M Bensghir2, A Hatim3, R Ahtil2, M Ait Houssa4, A Boulahya4, C Haimeur2, M Drissi3. 1. Pôle d'anesthésie-réanimation, hôpital militaire Mohammed V, 10100 Rabat, Maroc; Hôpital Militaire d'instruction Mohammed, 10100 Rabat, Maroc; Faculté de médicine et de pharmacie, Souissi, 10100 Rabat, Maroc; Université Mohammed V, Souissi, 10100 Rabat, Maroc. Electronic address: mistermeziane@hotmail.com. 2. Pôle d'anesthésie-réanimation, hôpital militaire Mohammed V, 10100 Rabat, Maroc; Hôpital Militaire d'instruction Mohammed, 10100 Rabat, Maroc; Faculté de médicine et de pharmacie, Souissi, 10100 Rabat, Maroc; Université Mohammed V, Souissi, 10100 Rabat, Maroc. 3. Service de réanimation de chirurgie cardiaque, hôpital militaire Mohammed V, 10100 Rabat, Maroc; Hôpital Militaire d'instruction Mohammed, 10100 Rabat, Maroc; Faculté de médicine et de pharmacie, Souissi, 10100 Rabat, Maroc; Université Mohammed V, Souissi, 10100 Rabat, Maroc. 4. Service de chirurgie cardiaque, hôpital militaire Mohammed V, 10100 Rabat, Maroc; Hôpital Militaire d'instruction Mohammed, 10100 Rabat, Maroc; Faculté de médicine et de pharmacie, Souissi, 10100 Rabat, Maroc; Université Mohammed V, Souissi, 10100 Rabat, Maroc.
Abstract
AIM: The aim of our study was to identify predictors for prolonged ICU stay following elective adult cardiac surgery under cardiopulmonary bypass. PATIENTS AND METHODS: A retrospective study was conducted during 5 years and a half period. Were included, patients age≥18 years old, underwent elective cardiac surgery under cardiopulmonary bypass. Patients who died within 48hours of surgery were excluded. Prolonged ICU stay was defined as stay in the ICU for 48hours or more. RESULTS: During the review period, 610 patients were included. One hundred and sixty-four patients have required a prolonged ICU stay (26.9 %). In multivariate analysis, 5 predictors were identified: ejection fraction<30 % (OR 19.991, IC 95 % [1.382-289.1], P=0.028], pulmonary hypertension (OR 2.293, IC 95 % [1.058-4.973], P=0.036), prolonged ventilation (≥12hours) (OR 4.026, IC 95 % [2.407-6.733], P<0.001). Number of blood units transfused (OR 1.568, IC 95 % [1.073-2.291], and postoperative acute renal failure (OR 2.620, IC 95 % [1.026-6.690], P=0.044]. Prolonged ICU stay is significantly associated with prolonged hospital stay (17 days vs 13 days ; P<0.001) and higher in hospital mortality (22 % vs. 3 %, P<0.001). CONCLUSION: The identification of these patients at risk of prolonged ICU stay is crucial. It will aid to plan prophylactic measures to optimize their support.
AIM: The aim of our study was to identify predictors for prolonged ICU stay following elective adult cardiac surgery under cardiopulmonary bypass. PATIENTS AND METHODS: A retrospective study was conducted during 5 years and a half period. Were included, patients age≥18 years old, underwent elective cardiac surgery under cardiopulmonary bypass. Patients who died within 48hours of surgery were excluded. Prolonged ICU stay was defined as stay in the ICU for 48hours or more. RESULTS: During the review period, 610 patients were included. One hundred and sixty-four patients have required a prolonged ICU stay (26.9 %). In multivariate analysis, 5 predictors were identified: ejection fraction<30 % (OR 19.991, IC 95 % [1.382-289.1], P=0.028], pulmonary hypertension (OR 2.293, IC 95 % [1.058-4.973], P=0.036), prolonged ventilation (≥12hours) (OR 4.026, IC 95 % [2.407-6.733], P<0.001). Number of blood units transfused (OR 1.568, IC 95 % [1.073-2.291], and postoperative acute renal failure (OR 2.620, IC 95 % [1.026-6.690], P=0.044]. Prolonged ICU stay is significantly associated with prolonged hospital stay (17 days vs 13 days ; P<0.001) and higher in hospital mortality (22 % vs. 3 %, P<0.001). CONCLUSION: The identification of these patients at risk of prolonged ICU stay is crucial. It will aid to plan prophylactic measures to optimize their support.