Objective
To determine the effect of intensive care unit (ICU) length of stay (LOS) on hospital
mortality and non-home discharge for patients undergoing cardiac surgery over a 16-year
period in Australia and New Zealand.
Design
A retrospective, multicenter cohort study covering the period January 1, 2004 to December
31, 2019.
Setting
One hundred one hospitals in Australia and New Zealand that submitted data to the
Australia New Zealand Intensive Care Society Adult Patient Database.
Participants
Adult patients (aged >18) who underwent coronary artery bypass grafting, valve surgery,
or combined valve + coronary artery surgery.
Interventions
None.
Measurements and Main Results
The authors analyzed 252,948 cardiac surgical patients from 101 hospitals, with a
median age of 68.3 years (IQR 60-75.5), of whom 74.2% (187,632 of 252,948) were male
patients. A U-shaped relationship was observed between ICU LOS and hospital mortality,
with significantly elevated mortality at short (<20 hours) and long (>5 days) ICU
LOS, which persisted after adjustment for illness severity and across clinically important
subgroups (odds ratio for mortality with ICU LOS >5 days = 3.21, 95% CI 2.88-3.58,
p < 0.001).
Conclusions
Prolonged duration of ICU LOS after cardiac surgery is associated with increased hospital
mortality in a U-shaped relationship. An ICU LOS >5 days should be considered a meaningful
definition for prolonged ICU stay after cardiac surgery.
Key Words
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Article info
Publication history
Published online: September 04, 2022
Footnotes
Mahesh Ramanan acknowledges a grant (AUD $10,000) received from The Common Good Foundation to support this work. Grant number: NI2020-24.
Identification
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