GE Yipeng , XU Jianping , Shi Yi , PAN Shiwei
  • (Adult Cardiac Surgery Center, Cardiovascular Institute and Fu Wai Hospital， Chinese Academy of Medical Sciences &;
  • Peking Union Medical College, Beijing 100037, P.R. China. E-mail:yipengge@hotmail.com);
Cardiac valvular surgery; Risk factor; Intensive care unit
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Objective To analyze risk factors for prolonged stay in intensive care unit (ICU) after cardiac valvular surgery. Methods
Between January 2005 and May 2005, five hundred and seven consecutive patients undergone cardiac valvular surgery were divided into two groups based on if their length of ICU stay more than 5 days (prolonged stay in ICU was defined as 5 days or more). Group Ⅰ: 75 patients required prolonged ICU stay. Group Ⅱ: 432 patients did not require prolonged ICU stay. Univariate and multivariate analysis (logistic regression) were used to identify the risk factors. Results Seventyfive patients required prolonged ICU stay. Univariate risk factors showed that age, the proportion of previous heart surgery, smoking history and repeat cardiopulmonary bypass (CPB) support, cardiothoracic
ratio, the CPB time and aortic crossclamping time of group Ⅰ were higher or longer than those of group Ⅱ. The heart function, left ventricular ejection fraction (LVEF), pulmonary function of group Ⅰwere worse than those of group Ⅱ(P lt;0.05, 0.01). Logistic regression identified that preoperative age≥65 years (OR=4.399), LVEF≤0.50(OR=2.788),cardiothoracic ratio≥0.68(OR=2.411), maximal voluntary ventilation observed value/predicted value % lt;71%(OR=4.872), previous heart surgery (OR=3.241) and repeat CPB support during surgery (OR=18.656) were final risk factors for prolonged ICU stay. Conclusion Prolonged ICU stay after cardiac valvular surgery can be predicted through age, LVEF, cardiothoracic ratio, maximal voluntary ventilation, previous heart surgery and repeat CPB support during surgery. The patients with these risk factors need more preoperative care and postoperative care to reduce mortality, morbidity and avoid prolonged ICU stay after cardiac valvular surgery.

Citation： GE Yipeng,XU Jianping,Shi Yi,PAN Shiwei,QIAN Xiangyang,LIU Feng.. Predictive Risk Factors for Prolonged Stay in Intensive Care Unit in Patients Undergoing Cardiac Valvular Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2007, 14(2): 85-88. doi: Copy