Predicted Factors of Prolonged Postoperative ICU Admission more than Four Days: Thai Tertiary University Hospital

Abstract

Objective: To identify the risk factors associated with prolonged intensive care unit admission (>4 days) and mortality in postoperative surgical patients.
Methods: A retrospective, case-control study was conducted in 527 patients admitted to postoperative intensive care units during a 1-year period. Fifteen factors were included in univariate and only significant factors were included in multivariate analyses.
Results: Twenty one percent of all admissions had prolonged length-of-stay. From multivariate analysis, predicted risk factors were emergency surgery (OR 2.9, p=0.001, CI 1.6-5.2); remained intubation (OR 2.6, p=0.007, CI 1.3-5.4), unplanned ICU admission (OR 2.1, p=0.03, CI 1.1-4.2); SAPS II score >52 (OR 4.8, p<0.001, CI 2.5-9.2), SAPS II score >64 (OR 6.1, p<0.001, CI 2.7-13.8) and inotrope infusion in ICU (OR 4.5, p<0.001, CI 2.5-8) which  were associated with prolonged ICU admission. Factors associated with ICU mortality (10.06%) were; ASA physical status >3 (OR 8.2, p=0.003, CI 2-32.9), ICU readmission (OR 3.9, p=0.007, CI 1.5-10.8), inotrope infusion in ICU (OR 3, p=0.006, CI 1.4-6.7), renal replacement therapy (OR 3.2, p=0.007, CI 1.3-8.2), SAPS II score 52-63 (OR 3.6, p=0.018, CI 1.2-6.8), SAPSII score >64 (OR 3.9, p=0.006, CI 1.4-9) and cirrhosis (OR 4.9, p=0.04, CI 1.1-21).
Conclusion: ASA physical status >3 and SAPS II score >52 were independent predictive factors of both prolonged intensive care unit admission and mortality.