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Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting

OBJECTIVE: Patients who have prolonged stay in intensive care unit (ICU) are associated with adverse outcomes. Such patients have cost implications and can lead to shortage of ICU beds. We aimed to develop a preoperative risk prediction tool for prolonged ICU stay following coronary artery surgery (...

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Autores principales: Ghotkar, Sanjay V, Grayson, Antony D, Fabri, Brian M, Dihmis, Walid C, Pullan, D Mark
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1526720/
https://www.ncbi.nlm.nih.gov/pubmed/16737548
http://dx.doi.org/10.1186/1749-8090-1-14
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author Ghotkar, Sanjay V
Grayson, Antony D
Fabri, Brian M
Dihmis, Walid C
Pullan, D Mark
author_facet Ghotkar, Sanjay V
Grayson, Antony D
Fabri, Brian M
Dihmis, Walid C
Pullan, D Mark
author_sort Ghotkar, Sanjay V
collection PubMed
description OBJECTIVE: Patients who have prolonged stay in intensive care unit (ICU) are associated with adverse outcomes. Such patients have cost implications and can lead to shortage of ICU beds. We aimed to develop a preoperative risk prediction tool for prolonged ICU stay following coronary artery surgery (CABG). METHODS: 5,186 patients who underwent CABG between 1st April 1997 and 31st March 2002 were analysed in a development dataset. Logistic regression was used with forward stepwise technique to identify preoperative risk factors for prolonged ICU stay; defined as patients staying longer than 3 days on ICU. Variables examined included presentation history, co-morbidities, catheter and demographic details. The use of cardiopulmonary bypass (CPB) was also recorded. The prediction tool was tested on validation dataset (1197 CABG patients between 1(st )April 2003 and 31(st )March 2004). The area under the receiver operating characteristic (ROC) curve was calculated to assess the performance of the prediction tool. RESULTS: 475(9.2%) patients had a prolonged ICU stay in the development dataset. Variables identified as risk factors for a prolonged ICU stay included renal dysfunction, unstable angina, poor ejection fraction, peripheral vascular disease, obesity, increasing age, smoking, diabetes, priority, hypercholesterolaemia, hypertension, and use of CPB. In the validation dataset, 8.1% patients had a prolonged ICU stay compared to 8.7% expected. The ROC curve for the development and validation datasets was 0.72 and 0.74 respectively. CONCLUSION: A prediction tool has been developed which is reliable and valid. The tool is being piloted at our institution to aid resource management.
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spelling pubmed-15267202006-08-04 Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting Ghotkar, Sanjay V Grayson, Antony D Fabri, Brian M Dihmis, Walid C Pullan, D Mark J Cardiothorac Surg Research Article OBJECTIVE: Patients who have prolonged stay in intensive care unit (ICU) are associated with adverse outcomes. Such patients have cost implications and can lead to shortage of ICU beds. We aimed to develop a preoperative risk prediction tool for prolonged ICU stay following coronary artery surgery (CABG). METHODS: 5,186 patients who underwent CABG between 1st April 1997 and 31st March 2002 were analysed in a development dataset. Logistic regression was used with forward stepwise technique to identify preoperative risk factors for prolonged ICU stay; defined as patients staying longer than 3 days on ICU. Variables examined included presentation history, co-morbidities, catheter and demographic details. The use of cardiopulmonary bypass (CPB) was also recorded. The prediction tool was tested on validation dataset (1197 CABG patients between 1(st )April 2003 and 31(st )March 2004). The area under the receiver operating characteristic (ROC) curve was calculated to assess the performance of the prediction tool. RESULTS: 475(9.2%) patients had a prolonged ICU stay in the development dataset. Variables identified as risk factors for a prolonged ICU stay included renal dysfunction, unstable angina, poor ejection fraction, peripheral vascular disease, obesity, increasing age, smoking, diabetes, priority, hypercholesterolaemia, hypertension, and use of CPB. In the validation dataset, 8.1% patients had a prolonged ICU stay compared to 8.7% expected. The ROC curve for the development and validation datasets was 0.72 and 0.74 respectively. CONCLUSION: A prediction tool has been developed which is reliable and valid. The tool is being piloted at our institution to aid resource management. BioMed Central 2006-05-31 /pmc/articles/PMC1526720/ /pubmed/16737548 http://dx.doi.org/10.1186/1749-8090-1-14 Text en Copyright © 2006 wGhotkar et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ghotkar, Sanjay V
Grayson, Antony D
Fabri, Brian M
Dihmis, Walid C
Pullan, D Mark
Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting
title Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting
title_full Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting
title_fullStr Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting
title_full_unstemmed Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting
title_short Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting
title_sort preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1526720/
https://www.ncbi.nlm.nih.gov/pubmed/16737548
http://dx.doi.org/10.1186/1749-8090-1-14
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