Risk factors for prolonged intensive care unit stays in patients after cardiac surgery with cardiopulmonary bypass: A retrospective observational study

Xueying Zhang; Wenxia Zhang; Hongyu Lou; Chuqing Luo; Qianqian Du; Ya Meng; Xiaoyu Wu; Meifen Zhang

doi:10.1016/j.ijnss.2021.09.002

Risk factors for prolonged intensive care unit stays in patients after cardiac surgery with cardiopulmonary bypass: A retrospective observational study

Int J Nurs Sci. 2021 Sep 7;8(4):388-393. doi: 10.1016/j.ijnss.2021.09.002. eCollection 2021 Oct 10.

Authors

Xueying Zhang¹, Wenxia Zhang², Hongyu Lou³, Chuqing Luo¹, Qianqian Du¹, Ya Meng¹, Xiaoyu Wu¹, Meifen Zhang¹

Affiliations

¹ School of Nursing, Sun Yat-Sen University, Guangzhou, China.
² Sun Yat-Sen University Cancer Center, Guangzhou, China.
³ Digestive Disease Center, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China.

Abstract

Objectives: Patients after cardiac surgery with cardiopulmonary bypass (CPB) require a stay in the ICU postoperatively. This study aimed to investigate the incidence of prolonged length of stay (LOS) in the ICU after cardiac surgery with CPB and identify associated risk factors.

Methods: The current investigation was an observational, retrospective study that included 395 ICU patients who underwent cardiac surgery with CPB at a tertiary hospital in Guangzhou from June 2015 to June 2017. Data were obtained from the hospital database. Binary logistic regression modeling was used to analyze risk factors for prolonged ICU LOS.

Results: Of 395 patients, 137 (34.7%) had a prolonged ICU LOS (>72.0 h), and the median ICU LOS was 50.9 h. Several variables were found associated with prolonged ICU LOS: duration of CPB, prolonged mechanical ventilation and non-invasive assisted ventilation use, PaO₂/FiO₂ ratios within 6 h after surgery, type of surgery, red blood cell infusion during surgery, postoperative atrial arrhythmia, postoperative ventricular arrhythmia (all P < 0.05).

Conclusions: These findings are clinically relevant for identifying patients with an estimated prolonged ICU LOS, enabling clinicians to facilitate earlier intervention to reduce the risk and prevent resulting delayed recovery.

Keywords: Cardiac surgery; Cardiopulmonary bypass; Intensive care units; Length of stay; Risk factors.