HealthResJ, health, medicine, nursing, research https://ejournals.epublishing.ekt.gr/index.php/HealthResJ/sitemap

Causes influencing the length of stay of cardiac surgery patients in the intensive care unit


Published: Oct 1, 2015
Keywords:
Open heart surgery prolonged hospitalization Intensive Care Unit complications
Nikoleta Dimitropoulou
Aggeliki Stamou
Christina Marvaki
Abstract

Introduction: The incidence of postoperative morbidity has increased, a fact which may lead to prolonged hospitalization of the patient in the Intensive Care Unit (ICU) and generally in the hospital.
Aim: The aim of the present study was to explore the complications after cardiac surgery responsible for the prolonged stay of patients in the ICU.
Material and method: The studied sample consisted of 80 patients who were hospitalized in the Intensive Care Unit General Hospital of Athens from January 2013 to June 2014. For data collection a special registration form with information coming from the medical records of patients was used. Data analysis was performed by the IBM SPSS 21.0 (Statistical Package for Social Sciences).
Results: Regarding to demographic characteristics Regarding the demographic characteristics and medical history of the studied sample, the majority were male (58.7%, n=47), with a mean age of 73 years and an average hospital stay of 3.3 days. The major causes of prolonged ICU stay was respiratory failure (20%, n=16), arrhythmias (17.5%, n = 14), bleeding (15%, n=12), myocardial infarction (11.3%, n=9), and pulmonary edema (10%,n=8). Τhe bivariate analysis showed statistical relationship to the level of 0,20 (p<0,20) between the prolonged ICU stay and age, coronary artery disease as the cause of entry, coronary artery bypass, diabetes melitus and chronic obstructive pulmonary disease.
Conclusion: Patients with a history of heart failure, diabetes or obstructive pulmonary disease seems to have a greater chance for a prolonged ICU stay after cardiac surgery. Early recognition of demographic and clinical factors that may lead to the prolonged ICU stay can provide very important information about how to improve perioperative care of the patient.

Article Details
  • Section
  • Original Articles
Downloads
Download data is not yet available.
References
Gruenberg DA, Shelton W, Rose SL, Rutter AE, Socaris S, McGee. Factors influencing length of stay in the intensive care unit. Am J Crit Care 2006; 15 (5): 509-9.
Eltheni R, Giakoumidakis K, Brokalaki H, Galanis P, Nenekidis I, Fildissis G.Predictors of Prolonged Stay in the Intensive Care Unit following Cardiac
Surgery.ISRN Nurs 2012;2012:691561.
Michalopoulos A, Tzelepis G, Pavides G, Kriaras J, Dafni U, Geroulanos S. J Determinants of duration of ICU stay after coronary artery bypass graft surgery. Br
J Anaesth 1996; 77 (2): 208-12.
Ghotkar SV, Grayson AD, Farbi BM, Dihmis WC, Pullan DM. Preoperative calculation of risk for prolonged, intensive care unit stay following coronary artery
bypass grafing. J Cardiothorac Surg 2006; 31; 1:14.
Nakasuji M , Matsushita M Asada A, J Anesth. Risk factors for prolonged ICU stay in patients following coronary artery bypass grafing with along duration of
cardiopulmonary bypass 2009; 19 (2): 118-23.
Christakis GT, Fremes SE, Naylor CD, Chen E, Rao V, Goldman BS. Impact of predperative risk and perioperative morbitity, on ICU stay following
Coronary bypass surgery. Cardiovasc Surg 1996; 4 (1): 29-35.
Xu J, Go Y, Pan S, Liu F, Shiy A. Preoperative and intra operative model of prolonged intensive Care unit stay for valvular surgery. J Heart Value Dis 2006; 15 (2):
-24.
Shelton W, Moore CD, Socaris S, Gao J, Dowling J.The effect of a family support intervention on family satisfaction, length-of-stay, and cost of care in the
intensive care unit.Crit Care Med 2010;38(5):1315- 20.
Moore CD, Bernardini GL, Hinerman R, Sigond K, Dowling J, Wang DB, Shelton W.The effect of a family support intervention on physician, nurse, and family
perceptions of care in the surgical, neurological, and medical intensive care units.Crit Care Nurs Q 2012;35(4):378-87.
Collins TC, Daley J, Henderson WH, Khuri SF.Risk factors for prolonged length of stay after major elective surgery.Ann Surg 1999;230(2):251-9.
De Maria R, Mazzoni M, Parolini M, Gregori D, Bortone F, Arena V, et al. Predictive value of EuroSCORE on long term outcome in cardiac surgery
patients: a single institution study.Heart 2005;91(6):779-84.
Celkan MA, Ustunsoy H, Daglar B, Kazaz H, Kocoglu H.Readmission and mortality in patients undergoing off-pump coronary artery bypass surgery with fasttrack
recovery protocol.Heart Vessels 2005;20(6):251-5.
Lazar HL, Fitzgerald C, Gross S, Heeren T, Aldea GS, Shemin RJ.Determinants of length of stay after coronary artery bypass graft surgery.Circulation 1995;92(9 Suppl):II20-4.
Azarfarin R, Ashouri N, Totonchi Z, Bakhshandeh H, Yaghoubi A. Factors influencing prolonged ICU stay after open heart surgery.Res Cardiovasc Med
;3(4):e20159.
Celkan MA, Ustunsoy H, Daglar B, Kazaz H, Kocoglu H.Readmission and mortality in patients undergoing off-pump coronary artery bypass surgery with fasttrack
recovery protocol.Heart Vessels 2005;20(6):251-5.
Hein OV, Birnbaum J, Wernecke K, England M, Konertz W, Spies C.Prolonged intensive care unit stay in cardiac surgery: risk factors and longterm-survival.Ann
Thorac Surg 2006;81(3):880-5.
Tu JV, Jaglal SB, Naylor CD.Multicenter validation of a risk index for mortality, intensive care unit stay, and overall hospital length of stay after cardiac surgery.
Steering Committee of the Provincial Adult Cardiac
Care Network of Ontario.Circulation 1995;91(3):677- 84.
Xu J, Ge Y, Pan S, Liu F, Shi Y.A preoperative and intraoperative predictive model of prolonged intensive care unit stay for valvular surgery.J Heart
Valve Dis 2006;15(2):219-24.
Messaoudi N, De Cocker J, Stockman BA, Bossaert LL, Rodrigus IE.Is EuroSCORE useful in the prediction of extended intensive care unit stay after cardiac
surgery?Eur J Cardiothorac Surg 2009;36(1):35-9.
Most read articles by the same author(s)