Key result
Prolonged ICU stay affects ~54% of infective endocarditis surgeries, linked to bypass time and vegetation size.
Why the study?
Prolonged ICU stay after cardiac surgery for infective endocarditis is common and associated with increased mortality and worse prognosis, but risk factors are not well defined.
Cohort (n=896)
No
INTRODUCTION: Prolonged intensive care unit (ICU) stay is common in serious patients undergoing cardiac surgery. Prolonged ICU stay is associated with increased mortality and worse prognosis. This study was conducted to determine the risk factors for prolonged ICU stay after cardiac surgery for infective endocarditis (IE) and we try to decrease the operative risk of mortality and morbidity of cardiac surgery for IE. METHODS: The retrospective study of patients with IE undergoing cardiac surgery between January 2006 and November 2022 at our hospital was performed. RESULTS: 896 patients undergoing cardiac surgery were divided into group of ICU stay ≤ 3d (n = 416) and group p of ICU stay > 3d (n = 480). There were 48 operative deaths (5.4%). Univariable and multivariable analyses showed that factors are associated with prolonged ICU stay following cardiac surgery for IE, including male (P < .001), age (P < .001), weight (P = .009), vegetation length (P < .001), paravalvular leak (P < .001), aortic cross-clamp time (P < .001), cardiopulmonary bypass (CPB) time (P < .001), mechanical ventilation time (P < .001), hospitalized time postoperative (P = .032), creatinine of serum before surgery (P < .001), creatinine of serum 24h after surgery (P = .005), creatinine of serum 48h after surgery (P < .001), fluid balance on operation day (P < .001), postoperative acute kidney injury (P < .001), left ventricular end diastolic dimension (LVEDD) preoperative (P < .001), LVEDD postoperative (P < .001), chest drainage (P = .032), frozen plasma (P = .016), preoperative aortic insufficiency (P < .001), and packed red cells (P < .001). CONCLUSIONS: In our study, shortness of ICU stay and optimization of pre-, peri-, and postoperative factors that can shorten ICU stay, therefore, contribute to a better postoperative outcome and leads to lower rates of mortality and morbidity.
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Huang et al. (2023) conducted a cohort in Infective endocarditis (n=896). Patient and operative risk factors (e.g., cardiopulmonary bypass time, vegetation length) vs. Absence or lower levels of risk factors was evaluated on Prolonged intensive care unit (ICU) stay (> 3 days). Prolonged intensive care unit stay (>3 days) occurred in 53.6% of patients undergoing cardiac surgery for infective endocarditis and was independently associated with multiple factors including increased cardiopulmonary bypass time (OR 1.015) and vegetation length (OR 1.070).
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