Prolonged stay in intensive care unit is a powerful predictor of adverse outcomes after cardiac operations

Mahesh Balakrishnan, Cliff Khuat Chye Choong, Kimberley A Goldsmith, Caroline Gerrard, Samer Nashef, Alain Vuylsteke

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30 Citations (Scopus)


BACKGROUND: The aim of this study was to examine the impact of prolonged intensive care unit (ICU) stay on in-hospital mortality and long-term survival. METHODS: Prospectively collected data from 6,101 consecutive patients who underwent surgery between 2003 and 2007 were analyzed. Prolonged ICU stay was defined as a total duration of ICU stay of 3 days or more postoperatively, including readmissions; patients with an ICU stay less than 3 days were identified as controls. Univariate and multiple variable analyses were performed to identify risk factors associated with prolonged ICU stay. RESULTS: Of 6,101 patients, 1,139 (18.7 ) patients had a prolonged ICU stay. These patients had a higher ICU mortality (10 ) compared with controls (0.6 ; p <0.001). On discharge from the ICU, their hospital mortality was still 6-fold higher (1.2 ) compared with controls (0.2 ; p <0.001). Finally, the patients who had prolonged ICU stays had lower survival after discharge from the ICU-89.2 and 81.2 at 1 year and 3 years, respectively, compared with 97.8 and 93.6 , respectively, for controls (p <0.001). Multiple variable analysis revealed prolonged ICU stay to be an independent predictor of prolonged hospital stay, higher hospital mortality, and poorer long-term survival (all p <0.001). CONCLUSIONS: Prolonged ICU stay is an important predictor of adverse immediate, short-term, and long-term outcomes after cardiac operations.
Original languageEnglish
Pages (from-to)109 - 116
Number of pages8
JournalThe Annals of Thoracic Surgery
Issue number1
Publication statusPublished - 2012

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