Risk Factors for Prolonged Length of Stay in the ICU Following Cardiac Surgery

Background Perioperative factors that affect the length of ICU stay after cardiac surgery are of special importance in planning the surgical intervention and the resources needed for recovery. Their exact identification is difficult. Possible reasons why they are not clearly defined is the lack of clear criteria as to what is prolonged ICU stay, the different end points, methodologies and the variety of risk factors included in the studies. Aim To identify factors leading to prolonged ICU stay in patients following cardiac surgery a year after their discharge from hospital. Materials and methods A three year retrospective controlled study from 01.01.2013 to 31.12.2015 at the University Hospital Sveta Ekaterina.163 patients were included in the study with a mean age of 67.18 10.36 years and a range of 36 to 79 years. Of those 126 (77.3 %) were men and 37 (22.7 %) were women with a men to women ratio of 3.41. The patients were divided into two groups study group with patients that spent 9 or more days in the ICU and control group with patients with an ICU stay of 3 days or less. Factors that were analyzed were gender, age, EuroSCORE, pulmonary arterial hypertension (PAH), long standing insulin dependent diabetes mellitus (greater than10 years), nosocomial infections, urinary infections, kidney failure, arterial hypertension (AH), COPD, NYHA heart failure class, past medical history of GI ulcers, , atrial fibrillation (AF), previous myocardial infarction (MI), pre-operative hemoglobin level, left ventricular ejection fraction (50 % vs.55 OR-2, 115, P-0, 039), AH 2 / greater than 2, OR-2, 137, P-0, 001), Ao cross-clamp time 40 / less than 40, OR-2, 508, P- 0, 025). Conclusion EuroSCORE over 5 %, EF less than 55 %, arterial hypertension grade II or more, CPB over 80 minutes and cross-clamp time over 40 minutes are factors leading to prolonged ICU stay. Knowing their effect can assist in better planning of the surgical intervention when resources.