Role of Surgeon in Length of Stay in ICU after Cardiac Bypass Surgery

BACKGROUND: We presumed that the surgeon himself has an impact on the results after coronary artery bypass grafting (CABG) as there is no unique protocol for the discharge of post-operative cardiac patients at our institution. Therefore, we examined whether the surgeon himself has an impact on the intensive care unit (ICU) stay of isolated CABG patients. METHODS: We prospectively studied a total of 570 consecutive patients undergoing elective CABG. Length of stay in the ICU was defined as the number of days in the ICU unit post-operatively. Seven operating surgeons were classified in 3 categories on the basis of the mean hospital stay of their patients (1, 2 and 3 if the mean total patients’ stay in hospital was <8 days, between 8 to 10 days, and longer than 10 days; respectively). Using a multivariable regression model, we determined the independent predictors of length of stay in the ICU (> 48 hours) and examined the role of surgeon in this regard. RESULTS: Incidence of post-operative arrhythmia and length of ICU stay were higher in the patients of surgeon category 3 than those of surgeon categories 1 and 2. Surgeon category 3 also operated on patients with higher EuroSCOREs than did surgeon categories 1 and 2. With the aid of a multivariable stepwise analysis, three variables were identified as independent predictors significantly associated with ICU length of stay: age, history of cerebrovascular accident, and surgeon category. CONCLUSION: Surgeon category may independently predict a prolonged length of stay in the ICU. We suggest that a unique discharge protocol for post-CABG patients be considered to restrict the role of surgeon in the ICU stay of these patients.