PERIOPERATIVE PREDICTORS LINKED WITH PROLONGED ICU STAY & SUBSEQUENT MORBIDITY AND MORTALITY AFTER CARDIAC SURGERY

DR. KHUSHBOO MITTAL; Dr. KHUSHALI TILVAWALA

Volume : VI, Issue : I, January - 2017

PERIOPERATIVE PREDICTORS LINKED WITH PROLONGED ICU STAY & SUBSEQUENT MORBIDITY AND MORTALITY AFTER CARDIAC SURGERY

Dr. Khushboo Mittal, Dr. Khushali Tilvawala

Abstract :

Aim: The aim of the present study was to evaluate the perioperative predictors linked with prolonged icu stay and subsequent morbidity and mortality after CABG (coronary artery bypass grafting)surgery.

Settings and design: This retrospective analytical study was conducted in a tertiary cardiac center.

Subjects and Methods: A total of 500 CABG surgery patients were recruited in the study over a period of 1.5 years & were retrospectively analysed for perioperative factors which included Preoperative, Intraoperative and Postoperative variables . Prolonged ICU stay was defined as > 96 hours and these patients were included in group І (n=50). Patients requiring less than 60 hours (n=450) stay were included in group II. Stepwise logistic regression analysis was performed. Results: The overall perioperative mortality was 6% (30 patients) with Group I showing a mortality rate of 44% (22 patients) and group ІІ showing 4 % (18 patients). In multivariate analysis, predictors of prolonged ICU stay were found to be EF < 40% (odds ratio(OR) 13.38), prolonged ventilation [OR 13.31], preoperative renal dysfunction [OR 4.06 (serum creatinine > 1.2mg%)] , prolonged CPB(cardio pulmonary bypass) time >120 min (OR 9.6) and reintervention-re-exploration/reintubation in the ICU (OR 13.8).

Conclusion-Identification of such perioperative variables may allow the development of strategies to optimize the patient�s condition and ICU management.