Photo Credit: Vital Hil

The following is a summary of “Factors affecting the duration of stay in the intensive care unit after coronary artery bypass surgery and its impact on in-hospital mortality: a retrospective study,” published in the February 2024 issue of Surgery by Ibrahim et al.

This study aimed to assess various risk factors influencing the duration of intensive care unit (ICU) stays following cardiac surgery. A retrospective analysis was conducted on data from 1070 patients (mean age: 59 ± 9.8 years) who underwent isolated coronary bypass grafting (CABG) surgery with cardiopulmonary bypass. 

The primary outcome measure was the prolonged length of stay (LOS) in the cardiac intensive care unit (CICU), defined as exceeding three nights post-CABG. Univariate analysis identified several predictors of prolonged ICU stays, including a left atrial diameter > 4 cm, chronic obstructive airway disease (COPD), hypertension, diabetes mellitus, coronary stents, preoperative beta-blocker use, intraoperative blood transfusion, postoperative acute kidney injury (AKI), prolonged inotropic or ventilation support, postoperative sepsis or pneumonia, stroke/transient ischemic attack (TIA), sternal wound infection, and postoperative atrial fibrillation (POAF). Multivariate regression analysis revealed that patients with a left atrial diameter > 4 cm, those not taking beta-blockers preoperatively, individuals requiring ventilation support > 12 hours, those developing postoperative pneumonia, and patients experiencing POAF were more likely to have ICU stays lasting > 3 nights following CABG surgery. 

These findings underscore the importance of addressing preoperative and postoperative factors to mitigate complications and reduce CICU length of stay, optimizing resource utilization and patient outcomes. Efforts to minimize these postoperative complications are warranted to expedite recovery, decrease healthcare costs, and enhance ICU bed availability.

Source: cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-024-02527-y