FACTORS INFLUENCING PROLONGED STAY IN THE INTENSIVE CARE UNIT AFTER CARDIAC SURGERY

Abstract

Background: There are different risk factors that affect the intensive care unit (ICU) stay after cardiac surgery. The aim of this study was to evaluate possible risk factors influencing prolonged ICU stay.

Methodology: We conducted 443 adult patients undergoing different cardiac surgery to determinate causes of prolonged ICU stay. These patients were divided into two groups according to ICU stay ≤ 4 days and >4 days. We evaluated preoperative, intraoperative and postoperative risk factors for prolong ICU stay.

Results: Among the 443 patients studied, 277 (62.52%) had stayed ≤ 4 days and 166 (37.42%) had stayed >4 days in ICU. Frequency of prolonged ICU stay was 42.7% in patients undergoing coronary artery bypass graft (CABG), 37.3% in patients with valve surgery, 9% in patients with CABG plus valve surgery and 10.8% others surgery. Patients with > 4 days of ICU stay received more blood transfusion and higher inotropes duration. They also had longer time duration of surgery, cardiopulmonary bypass, and long ventilation hours and other preoperative and postoperative risk factors. (P < 0.05 for all comparisons).

Conclusions: The relationships between the pre-, intra- and postoperative risk factors and prolonged ICU stay after coronary artery bypass grafting with cardiopulmonary bypass, suggest that serum creatinine, urea and liver dysfunction were risk factors for prolong ICU stay, Whereas among surgical variables cardio pulmonary bypass time, cross clamp time and time duration of surgery are the main associates of higher ICU duration.