scholarly journals Prevalence and Risk Factors for Prolonged ICU Stay After Adult Cardiac Surgery

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Mousa Mirinazhad ◽  
Dalir Parsa ◽  
Gholamreza Faridaalaee ◽  
Eissa Bilehjani ◽  
Mohammad Irajian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Icu Stay ◽  
Prolonged Icu Stay ◽  
Adult Cardiac Surgery

Pattern Recognition of Risk Factors for Prolonged ICU Stay after Cardiac Surgery

2015 ◽  
Vol 63 (S 01) ◽  
Author(s):  
R.M. Brouwer ◽  
D. Pahari ◽  
A. El-Essawi ◽  
T. Vries ◽  
W. Harringer
Keyword(s):  
Risk Factors ◽  
Pattern Recognition ◽  
Cardiac Surgery ◽  
Icu Stay ◽  
Prolonged Icu Stay

Prognostic Value of GDF-15 in Predicting Prolonged Intensive Care Stay following Cardiac Surgery: A Retrospective Case-Control Study

2021 ◽  
Author(s):  
Henry Barton ◽  
Elisabeth Zechendorf ◽  
Dirk Ostareck ◽  
Antje Ostareck-Lederer ◽  
Christian Stoppe ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Confidence Interval ◽  
Prediction Models ◽  
Unit Length ◽  
Icu Stay ◽  
Intensive Care Stay ◽  
Cardio Pulmonary Bypass ◽  
Prolonged Icu Stay ◽  
Pulmonary Bypass

Abstract Background: Predicting intensive care unit length of stay and outcome following cardiac surgery is currently based on clinical parameters. Novel biomarkers could be employed to improve the prediction models. Methods: We performed a qualitative cytokine screening array to identify highly expressed biomarkers in preoperative blood samples of cardiac surgery patients. After identification of one highly expressed biomarker, growth differentiation factor 15 (GDF-15), a quantitative ELISA was undertaken. Preoperative levels of GDF-15 were compared in regard to duration of intensive care stay, cardio-pulmonary bypass time and indicators of organ dysfunction.Results: Preoperatively, GDF-15 was highly expressed in addition to several less highly expressed other biomarkers. After qualitative analysis we could show that preoperatively raised levels of GDF-15 was positively associated with prolonged ICU stay exceeding 48 h (median 713 versus 1041 pg/ml, p = 0.003). It was also associated with prolonged mechanical ventilation and rates of severe sepsis but not with dialysis rates or cardio-pulmonary bypass time. In univariate regression, raised GDF-15 levels were predictive of a prolonged ICU stay (OR 1.01, 95% Confidence Interval 1 – 1.02, p= 0.029). On ROC curves, GDF-15 was found to predict prolonged ICU stay (AUC= 0.86, 95% Confidence Interval 0.71 – 0.99, p= 0.003).Conclusion: GDF-15 showed potential as predictor of prolonged intensive care stay following cardiac surgery, which might be valuable for risk stratification models.

scholarly journals Applying the Gender Lens to Risk Factors and Outcome after Adult Cardiac Surgery

2014 ◽  
Vol 30 (2) ◽  
pp. 6-6 ◽  
Author(s):  
Sandra Eifert ◽  
Sonja Guethoff ◽  
Ingo Kaczmarek ◽  
Andres Beiras-Fernandez ◽  
Ute Seeland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Gender Lens ◽  
Adult Cardiac Surgery

scholarly journals Predictors of postoperative complication and prolonged intensive care unit stay after complete pericardiectomy in tuberculous constrictive pericarditis

2020 ◽  
Author(s):  
Likui Fang ◽  
Guocan Yu ◽  
Jinpeng Huang ◽  
Wuchen Zhao ◽  
Bo Ye
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Postoperative Complication ◽  
Constrictive Pericarditis ◽  
Functional Class ◽  
Cox Regression Analysis ◽  
Nyha Functional Class ◽  
Icu Stay ◽  
Prolonged Icu Stay

Abstract Purpose The risk factors of postoperative outcomes after pericardiectomy in tuberculous constrictive pericarditis have still been unclear. This study aimed to investigate the predictors of postoperative complication and prolonged intensive care unit (ICU) stay in the patients with tuberculous constrictive pericarditis undergoing pericardiectomy. Methods A total of 88 patients with tuberculous constrictive pericarditis undergoing pericardiectomy were retrospectively enrolled. Logistic regression and Cox regression analysis were performed to identify the predictors of postoperative complication and prolonged ICU stay, respectively. Results All patients underwent complete pericardiectomy and 35 (39.8%) had postoperative complications with no mortality within 30 days after surgery. Postoperative complication delayed postoperative ICU stay (P < 0.001), duration of chest drainage (P < 0.001) and postoperative hospital stay (P < 0.001). Preoperative NYHA functional class (P = 0.004, OR 4.051, 95%CI 1.558–10.533) and preoperative central venous pressure (CVP) (P = 0.031, OR 1.151, 95%CI 1.013–1.309) were independent risk factors of postoperative complication. Postoperative complication (P < 0.001, HR 4.132, 95%CI 2.217–7.692) was the independent risk factor for prolonged ICU stay. Conclusion Complete pericardiectomy was associated with high risk of postoperative complication in tuberculous constrictive pericarditis. Poor preoperative NYHA functional class and high preoperative CVP were shown to predict postoperative complication which was the predictor of prolonged ICU stay.

Risk Factors for the Development of Nosocomial Pneumonia and Its Clinical Impact in Cardiac Surgery

2021 ◽  
Author(s):  
Ferdinand Jr Rivera Gerod ◽  
Edgar Ongjoco ◽  
Rod Castro ◽  
Armin Masbang ◽  
Elmer Casley Repotente ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Hospital Mortality ◽  
Nosocomial Pneumonia ◽  
Clinical Impact ◽  
Adult Patients ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Prolonged Icu Stay

Abstract BackgroundThe development of nosocomial pneumonia after cardiac surgery is a significant post-operative complication that may lead to increased morbidity, mortality, and hospital cost. We aimed to identify risk factors associated with it and to determine its clinical impact in terms of in-hospital mortality and morbidity.MethodsThis is a retrospective cohort study conducted among all adult patients who underwent cardiac surgery from 2014-2019 in St. Luke’s Medical Center, Quezon City, Philippines. Baseline characteristics and possible risk factors for pneumonia were retrieved from medical records. Nosocomial pneumonia was based on the Centers for Disease Control and Prevention criteria. Clinical outcomes include in-hospital mortality and morbidity. Odds ratios from logistic regression was computed to determine risk factors associated with pneumonia using STATA 15.0.ResultsOut of 373 patients included in this study, 104 (28%) patients acquired pneumonia. Most surgeries were coronary artery bypass graft (CABG) (71.58%), followed by valve repair/replacement (29.76%). Neither age, sex, BMI, diabetes, LV dysfunction, renal dysfunction, COPD/asthma, urgency of surgery, surgical time, nor smoking showed association in the development of pneumonia. However, preoperative stay of >2 days was associated with 92.3% (95%CI 18–213%) increased odds of having pneumonia (p=.009). Also, every additional hour on mechanical ventilation conferred 0.8% (95%CI, 0.3–1%) greater odds of acquiring pneumonia (p=.003).Patients who developed pneumonia had 3.9 times odds of mortality (95%CI 1.51–9.89, p=.005), 3.8 times odds of prolonged hospitalization (95%CI 1.81–7.90,p<.001), 6.4 times odds of prolonged ICU stay (95%CI 3.59–11.35,p<.001), and 9.5 times odds of postoperative reintubation (95%CI 3.01–29.76,p<.001). ConclusionAmong adult patients undergoing cardiac surgeries, prolonged preoperative hospital stay and prolonged mechanical ventilation were both associated with an increased risk for nosocomial pneumonia. Those who developed pneumonia had worse outcomes with significantly increased in-hospital mortality, prolonged hospitalization, prolonged ICU stay, and increased postoperative re-intubation. Clinicians should therefore minimize delays in surgery to avoid unnecessary exposure to pathogenic organisms. Also, timely liberation from mechanical ventilation after surgery should be encouraged.

scholarly journals VENTILATORY SUPPORT WITH THE USE OF NIV, NON-REBREATHABLE MASK AND PRONE VENTILATION IN A COVID PATIENT

2020 ◽  
pp. 16-17
Author(s):  
K. Arun Vishnu ◽  
Athul.C. Angaj ◽  
Trinath Dash
Keyword(s):  
Risk Factors ◽  
Respiratory Function ◽  
Ventilatory Support ◽  
Respiratory Illness ◽  
Invasive Ventilation ◽  
The Past ◽  
Icu Stay ◽  
Prolonged Icu Stay

VENTILATORY SUPPORT HAS BEEN GAINING IMPORTANCE AND MOMENTUM IN THE PAST DUE TO RESPIRATORY ILLNESS LIKE COPD, ASTHMA AND ALSO IN THE PRESENT IN VIEW OF THE CURRENT ON GOING PANDEMIC WHERE MAINTAINING THE RESPIRATORY FUNCTION WITH OPTIMUM OXYGENATION IN A PATIENT HAS BEEN A LOT CHALLENG DUE TO VARIOUS RISK FACTORS. WE HEREBY ARE GOING TO DISCUSS ABOUT A CASE OF COVID 19 AND LATER DEVELOPED POST-COVID FIBROSIS. HE WAS MANAGED WITH VARIOUS MODES OF VENTILATORY SUPPORTS OF A PROLONGED ICU STAY WITH OUT INVASIVE VENTILATION, AND LATER DISCHARGED.

scholarly journals Evaluation of Usefulness of Mannheim Peritonitis Index and APACHE II Score in Predicting Mortality and Morbidity in Patients with Peritonitis- A Prospective Diagnostic Test Study

2020 ◽  
Author(s):  
D Paul Trinity Stephen ◽  
Vijay Abraham ◽  
Reka Karuppusami
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Sensitivity And Specificity ◽  
Apache Ii ◽  
Secondary Outcome ◽  
Apache Ii Score ◽  
Mannheim Peritonitis Index ◽  
Mortality And Morbidity ◽  
Icu Stay ◽  
Prolonged Icu Stay

Introduction: Peritonitis, defined as inflammation of the peritoneal cavity can be of various causes, and is one of the most common surgical emergencies. This continues to be a challenge to diagnose and treat. Early intervention is essential to select patients who will need intensive care which brings out better outcome for the patients. This also helps us use the resources optimally. Over years, many scoring systems have been developed and studied to predict outcomes in patients with peritonitis. Aim: To evaluate the ability of Mannheim Peritonitis Index (MPI) and APACHE II (Acute Physiology And Chronic Health Evaluation II) scores in predicting mortality and morbidity in patients with peritonitis. Materials and Methods: A prospective, observational study was conducted at Christian Medical College and Hospital, Vellore, Tamil Nadu, India, for a period of two years from September 2014 to August 2016. A total of 78 patients were recruited for this study. These patients were scored with MPI and APACHE II scores. The primary outcome studied was in hospital death or discharge. The secondary outcome studied was morbidity in terms of local and systemic complications. The risk factors associated with mortality in patients with peritonitis were also studied. The best cut-off value for MPI and APACHE II from the data was calculated using Yuden index. The sensitivity, specificity and likelihood ratios were calculated and presented with 95% Confidence Interval(CI). The sub-group analysis was done for risk factors and complications. Results: There were more males than females. Age ≥48 years (p=0.002) and serum creatinine ≥1.3 g/dL (p=0.012) were found to be significant risk factors for mortality. The sensitivity and specificity of MPI ≥27 in predicting mortality was found to be 90% and 57% respectively. The sensitivity and specificity of APACHE II score ≥10 in predicting mortality was found to be 40% and 78%, respectively. MPI scores ≥27 were strongly associated with morbidity like prolonged ICU stay (p=0.004), mechanical ventilation requirement (p=0.001) and need for dialysis (p=0.035). Conclusion: Present study showed MPI to be a better predictor of mortality than APACHE II, though APACHE II showed better specificity. MPI score also was helpful in predicting morbidity such as prolonged ICU stay, mechanical ventilation requirement postoperatively and need for dialysis postoperatively. MPI was easier to use as it contained lesser variables. MPI could be of use in rural areas with no facility for laboratory investigations and blood gas analysis.

Risk factors for postoperative bleeding after adult cardiac surgery]]>

2004 ◽  
Vol 19 (3) ◽  
Author(s):  
Leonardo A. Miana ◽  
Fernando A. Atik ◽  
Luiz F. Moreira ◽  
Alexandre C. Hueb ◽  
Fabio B. Jatene ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Postoperative Bleeding ◽  
Adult Cardiac Surgery
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