Document Detail


Preoperative prediction of prolonged stay in the intensive care unit for coronary bypass surgery.
MedLine Citation:
PMID:  14747113     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To construct a predictive model for a prolonged stay in the intensive care unit (ICU) for coronary artery bypass graft surgery (CABG). METHODS: Eight hundred and eighty-eight patients undergoing CABG were studied by univariate and multivariate analysis. Prolonged stay in the ICU was defined as >/=3 days stay. Stepwise selective procedure (P</=0.05) was used to identify a subset of variables with prognostic value for prolonged stay. This subset was used to calculate a prognostic score S and predicted probability P (P=1/1+e(-S)). Sensitivity analysis was used for evaluation. RESULTS: Significant risk factors for prolonged stay in the ICU were: lung disease, no-sinus rhythm, no-mild valve pathology, reoperation, no-elective operation, and no-off-pump procedure. The receiver operating characteristic curve gave an area under the curve value of 0.68 for prolonged stay in ICU. Observed probabilities compared well with the predicted probabilities. Patients were classified into low (5%), intermediate (15%), high (30%), and very high-risk groups (40%). A predicted probability of >/=0.40 was used as cut-off point for the prognostic test. The specificity of this test for prolonged stay in the ICU was 99%; sensitivity 9%; positive predictive value 60%; and negative predictive value 89%. CONCLUSIONS: The results show that individual patients presented for CABG, can be stratified according to their risk for prolonged stay >/=3 days in the ICU.
Authors:
Douglas P B Janssen; Luc Noyez; Constantijn Wouters; Rene M H J Brouwer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  25     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-01-28     Completed Date:  2004-04-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  203-7     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiac Surgery, Free University Medical Center, P.O. Box 7057, 1081 HV, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Coronary Artery Bypass*
Epidemiologic Methods
Female
Humans
Intensive Care Units*
Length of Stay*
Lung Diseases / complications
Male
Middle Aged
Netherlands
Postoperative Care
Postoperative Complications / therapy
Prognosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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