eComment. Costs, nursing administrators and predictors of intensive care unit length of stay

The intensive care unit (ICU) takes a significant proportion of the total healthcare cost, and therefore patients with prolonged lengths of stay (LOS) have serious cost implications. The authors have developed a model to more specifically predict ICU-LOS as compared to other mortality-prediction risk models [1]. Moreover, the authors have identified a significant correlation between preoperative and intraoperative variables and prolonged ICU-LOS. The present study allows members of the cardiac surgical community in low and middle income countries to reach significant conclusions regarding the preoperative and intraoperative factors that could influence the ICU-LOS among cardiac surgery patients. In addition, this study is among few European studies aiming to investigate parameters that could predict ICU-LOS and, consequently, to help in making administrative decisions regarding the planning of operations, provided care and ICU resource allocation, especially when it comes to reducing healthcare costs [2, 3]. Most importantly, the ICU-LOS is often a subjective outcome that is affected by the opinion of the intensive care specialists or a busy operations schedule [4]. To the best of our knowledge, some hospitals are more comfortable transferring patients out to a lower acuity nursing environment (nurse-led clinics) than other hospitals [5]. The different cut-off points of the ICU-LOS impede the ability to compare findings from corresponding international literature. Nursing administrators may use this knowledge for the appropriate use of the limited ICU, human and financial resources in today's healthcare systems in middle income European countries. In addition, they have the opportunity to more efficiently and effectively plan operations, select low-risk patients despite significant restriction in the ICU beds availability. This is of great importance, especially for public healthcare systems in middle income European countries, characterized by limited resources, nursing staff and ICU-bed shortage. Conflict of interest: none declared