Key result
Erythrocyte suspension transfusion during intensive care significantly increased the odds of a prolonged ICU stay greater than 24 hours in elderly cardiac surgery patients (OR 2.946).
Why the study?
The number of patients undergoing open-heart surgery has increased with longer life expectancy and developments in surgical, anesthetic, and intensive care techniques.
Observational (n=220)
No
Odds Ratio: 2.946 (95% CI 1.746–4.969)
p-value: p=<0.001
Prolonged ICU stays in elderly patients after cardiac surgery are significantly associated with longer extubation times, higher first-day drainage, and the need for erythrocyte suspension transfusions.
Should not yet change transfusion practices in elderly cardiac surgery patients; observational association leaves causality open for randomized confirmation.
Introduction: With the increase in life expectancy and developments in surgical and anesthetic techniques, intensive care follow-up, and treatment methods, the number of patients undergoing open-heart surgery has increased. Methods: The clinical files of 220 patients who underwent cardiovascular surgery were retrospectively reviewed. The patients were divided into two groups: group 1 (those who stayed for one day or less) and group 2 (those who stayed for more than one day). In addition, the reason for hospitalization for five days or more was investigated. The effect of patient variables on the length of stay in the intensive care unit was investigated by logistic regression analysis. Results: Hemoglobin values, ejection fraction values, and intensive care unit hospitalizations were significantly lower (p<0.05) than those in the group with intensive care unit hospitalizations of <24 h. The sodium value was significantly higher (p<0.05) in the group with intensive care unit hospitalizations >24 h than in the group with intensive care unit hospitalizations <24 h. The pacemaker requirement rate in the group with intensive care unit hospitalizations >24 h was significantly (p<0.05) higher than the group with intensive care unit hospitalizations < 24 h. The sinus rhythm in the group with intensive care unit hospitalizations >24 h was significantly lower (p<0.05) than that in the group with intensive care unit hospitalizations <24 h. Intensive care transfusion of erythrocyte suspension, fresh frozen plasma, and platelet suspension were significantly higher (p<0.05) in the group with intensive care unit hospitalizations >24 h than in the group with intensive care unit hospitalizations <24 h. Conclusion: In our study; We found that factors such as preoperative low ejection fraction (EF), hypernatremia, female gender, inotrope requirement, delirium, extubation time, intraoperative-postoperative transfusion, drainage revision affect the length of stay in the intensive care unit In the intraoperative period, methods to protect myocardial and kidney functions and provide hemostasis bleeding control reduce the duration of intensive care hospitalization Keywords: Thoracic Surgery; Length of Stay; Critical Care; Aging.
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Balkan et al. (2023) conducted an observational in Patients undergoing cardiovascular surgery (n=220). Erythrocyte suspension transfusion in ICU vs. No or lower erythrocyte suspension transfusion was evaluated on Prolonged ICU stay (>24 hours) (OR 2.946, 95% CI 1.746-4.969, p=<0.001). Erythrocyte suspension transfusion during intensive care significantly increased the odds of a prolonged ICU stay greater than 24 hours in elderly cardiac surgery patients (OR 2.946).
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