Volume : 6, Issue : 1, January - 2017

PERIOPERATIVE PREDICTORS LINKED WITH PROLONGED ICU STAY & SUBSEQUENT MORBIDITY AND MORTALITY AFTER CARDIAC SURGERY

Dr. Khushboo Mittal, Dr. Khushali Tilvawala

Abstract :

<p>&nbsp;<b><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">Aim</span></b><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">:</span><span class="apple-converted-space"><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">&nbsp;</span></span><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">The aim of the present study was </span><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif;">&nbsp;to evaluate the perioperative predictors linked with prolonged icu stay and subsequent morbidity and mortality after CABG (coronary artery bypass grafting)surgery.</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-size:10.0pt;font-family:&quot;Camia&quot;,serif;&#10;mso-bidi-font-style:italic">Settings and design</span></b><span lang="EN-IN" style="font-size:10.0pt;font-family:&quot;Camia&quot;,serif;mso-bidi-font-style:italic">:</span><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"> This retrospective analytical study was conducted in a tertiary cardiac center.</span><span lang="EN-IN" style="font-size:10.0pt;font-family:&quot;Camia&quot;,serif;mso-bidi-font-style:italic"><o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">Subjects and Methods</span></b><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">:</span><span class="apple-converted-space"><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">&nbsp;</span></span><span lang="EN-IN" style="font-size: 10pt; font-family: Camia, serif; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">A total of 500 CABG surgery patients were recruited in the study over a period of 1.5 years &amp; </span><span lang="EN-IN" style="font-size:10.0pt;font-family:&#10;&quot;Camia&quot;,serif;mso-bidi-font-style:italic">were retrospectively analysed for perioperative factors which included Preoperative, &nbsp;Intraoperative and Postoperative variables . Prolonged ICU stay was defined as </span><span lang="EN-IN" style="font-size:&#10;10.0pt;font-family:&quot;Camia&quot;,serif;mso-bidi-font-family:Symbol">&gt; 96</span><span lang="EN-IN" style="font-size:10.0pt;font-family:&quot;Camia&quot;,serif;mso-bidi-font-style:&#10;italic"> hours and these patients were included in group І (n</span><span lang="EN-IN" style="font-size:10.0pt;font-family:&quot;Camia&quot;,serif">=50). Patients requiring less than 60 hours (n=450) stay were included in group II. Stepwise logistic regression analysis was performed. <b>R</b></span><b><span lang="EN-IN" style="mso-bidi-font-size:&#10;10.0pt;font-family:&quot;Camia&quot;,serif;mso-bidi-font-style:italic">esults</span></b><span lang="EN-IN" style="mso-bidi-font-size:10.0pt;font-family:&quot;Camia&quot;,serif;&#10;mso-bidi-font-style:italic">:</span><span lang="EN-IN" style="font-size:10.0pt;&#10;font-family:&quot;Camia&quot;,serif;mso-bidi-font-style:italic"> The overall perioperative mortality was 6% (30 patients) with Group I showing a mortality rate of 44% (22 patients) and group ІІ showing 4 % (18 patients). In multivariate analysis, predictors of prolonged ICU stay were found to be EF &lt; 40% (odds ratio(OR) 13.38), prolonged ventilation [OR 13.31], preoperative renal dysfunction [OR 4.06 (serum creatinine &gt; 1.2mg%)] , prolonged CPB(cardio pulmonary bypass) time &gt;120 min (OR 9.6) and reintervention-re-exploration/reintubation in the ICU (OR 13.8). <o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;normal;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-size:10.0pt;font-family:&quot;Camia&quot;,serif;&#10;mso-bidi-font-style:italic">Conclusion</span></b><span lang="EN-IN" style="font-size:10.0pt;font-family:&quot;Camia&quot;,serif;mso-bidi-font-style:italic">-Identification of such perioperative variables may allow the development of strategies to optimize the patient&rsquo;s condition and ICU management.<o:p></o:p></span></p>

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Cite This Article:

DR. KHUSHBOO MITTAL, Dr. KHUSHALI TILVAWALA, PERIOPERATIVE PREDICTORS LINKED WITH PROLONGED ICU STAY & SUBSEQUENT MORBIDITY AND MORTALITY AFTER CARDIAC SURGERY, GLOBAL JOURNAL FOR RESEARCH ANALYSIS : Volume-6, Issue-1, January‾2017


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