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Algengi og áhættuþættir lengdrar dvalar á gjörgæsludeild eftir kransæðahjáveituaðgerð

Algengi og áhættuþættir lengdrar dvalar á gjörgæsludeild eftir kransæðahjáveituaðgerð


Title: Algengi og áhættuþættir lengdrar dvalar á gjörgæsludeild eftir kransæðahjáveituaðgerð
Alternative Title: Incidence and predictors of prolonged intensive care unit stay after coronary artery bypass in Iceland
Author: Gunnarsdóttir, Erla Liu Ting
Gunnarsdóttir, Sunna Lu Xi
Heimisdóttir, Alexandra Aldís
Heiðarsdóttir, Sunna Rún
Helgadóttir, Sólveig
Guðbjartsson, Tómas
Sigurðsson, Martin Ingi
Date: 2020-03
Language: Icelandic
Scope: 7
University/Institute: Landspítali
Department: Læknadeild
Hjarta- og æðaþjónusta
Skurðstofur og gjörgæsla
Series: Laeknabladid; 106(3)
ISSN: 0023-7213
DOI: https://doi.org/10.17992/lbl.2020.03.471
Subject: 30 day mortality; CABG; Complications; Coronary artery bypass grafting; Intensive care unit; Length of stay; Outcome; Hjáveituaðgerðir; Kransæðahjáveituaðgerðir; Gjörgæsla; Coronary Artery Bypass; Intensive Care Units; Hjáveituaðgerðir; Kransæðahjáveituaðgerðir; Gjörgæsla; Coronary Artery Bypass; Intensive Care Units; Læknisfræði (allt)
URI: https://hdl.handle.net/20.500.11815/3392

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Citation:

Gunnarsdóttir , E L T , Gunnarsdóttir , S L X , Heimisdóttir , A A , Heiðarsdóttir , S R , Helgadóttir , S , Guðbjartsson , T & Sigurðsson , M I 2020 , ' Algengi og áhættuþættir lengdrar dvalar á gjörgæsludeild eftir kransæðahjáveituaðgerð ' , Laeknabladid , bind. 106 , nr. 3 , bls. 123-129 . https://doi.org/10.17992/lbl.2020.03.471

Abstract:

Introduction: To maximize the use of intensive care unit (ICU) resources, it is important to estimate the prevalence and risk factors for prolonged ICU unit stay after coronary artery bypass grafting (CABG) surgery. Material and methods: This retrospective cohort study included all patients who underwent primary isolated CABG at Landspitali between 2001 and 2018. Patient information was collected from hospital charts and death registries. Patients who stayed in the ICU for the conventional one night postoperatively were compared with those who needed longer stays in the ICU. Survival rate was estimated with the Kaplan-Meier method. Predictors for prolonged ICU stay were calculated with logistic regression and the outcome used to create a calculator that estimates the probability of prolonged ICU stay. Results: Out of 2177 patients, 20% required prolonged ICU stay. Patients with prolonged stay were more frequently female (23% vs 16%, p=0.001), had a higher rate of cardiovascular risk factors and higher EuroSCORE II (4.7 vs. 1.9, p<0.001). They also had a higher rate of impaired renal function before surgery (14% vs. 4%, p<0.001) and emergent surgery (18% vs. 2%, p<0.001). Furthermore, these patients had higher rates of both short-term and long-term complications, and lower long-term survival (85% vs 68% five-year survival rate, p<0.0001). Independent risk factors for prolonged ICU stay were advanced age, female gender, EuroSCORE II, history of heart diseases, impaired renal function and emergent surgery. Conclusions: Every fifth patient had a prolonged ICU stay after CABG. Several risk factors predicted prolonged ICU stay after CABG, in particular patients' medical condition before surgery, EuroSCORE II and emergent surgery. A better understanding of the risk factors for prolonged ICU stay will hopefully aid in scheduling CABG surgeries at Landspitali.

Description:

Þakkir fá læknar á hjarta- og lungnaskurðdeild og gjörgæsludeild Landspítala. Rannsóknin var styrkt af Vísindasjóði Landspítala og Rannsóknasjóði Háskóla Íslands. Publisher Copyright: © 2020 Laeknafelag Islands. All rights reserved.

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