Factors influencing length of intensive care unit stay following a bidirectional cavopulmonary shunt. (19th March 2021)

• Record Type: Journal Article
• Authors: Kido, Takashi; Ono, Masamichi; Anderl, Lisa; Burri, Melchior; Strbad, Martina; Balling, Gunter; Cleuziou, Julie; Hager, Alfred; Ewert, Peter; Hörer, Jürgen
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 33:Number 1(2021)
• Page Start: 124
• Page End: 130
• Publication Date: 2021-03-19
• Subjects: Univentricular heart -- Single ventricle -- Long-term follow-up -- Risk factors -- Bidirectional cavopulmonary shunt -- Length of ICU stay -- Pulmonary artery pressure -- Mortality; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivab061
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: : OBJECTIVES: The goal of this study was to identify the risk factors for prolonged length of stay (LOS) in the intensive care unit (ICU) after a bidirectional cavopulmonary shunt (BCPS) procedure and its impact on the number of deaths. METHODS: In total, 556 patients who underwent BCPS between January 1998 and December 2019 were included in the study. RESULTS: Eighteen patients died while in the ICU, and 35 died after discharge from the ICU. Reduced ventricular function was significantly associated with death during the ICU stay ( P = 0.002). In patients who were discharged alive from the ICU, LOS in the ICU [hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.02–1.06; P < 0.001] and a dominant right ventricle (HR 2.41, 95% CI 1.03–6.63; P = 0.04) were independent risk factors for death. Receiver operating characteristic analysis identified a cut-off value for length of ICU stay of 19 days. Mean pulmonary artery pressure (HR 1.03, 95% CI 1.01–1.05; P = 0.04) was a significant risk factor for a prolonged ICU stay. CONCLUSIONS: Prolonged LOS in the ICU with a cut-off value of 19 days after BCPS was a significant risk factor for mortality. High pulmonary artery pressure at BCPS was a significant risk factor for a prolonged ICU stay.