Cardiac intensivist UAB Birmingham, Alabama, United States
Abstract:
Background: Long hospital stays for neonates following cardiac surgery can be detrimental to short- and long-term outcomes. Furthermore, it can impact resource allocation within heart centers' daily operations. We aimed to explore multiple clinical variables and complications that can influence and predict the postoperative hospital length of stay.
Methods: We conducted a retrospective observational review of the full term neonates ( < 30 days old) who had cardiac surgery in a tertiary pediatric cardiac surgery center—assessment of multiple clinical variables and their association with postoperative hospital length of stay.
Results: 273 neonates were screened with a mortality rate of 8%. The survivors (number=251) were analyzed; 83% had at least one complication. The median postoperative hospital length of stay was 19.5 days (Interquartile range 10.5, 31.6 days). The median postoperative hospital length of stay was significantly different amongst patients with complications (21.5 days, 10.5, 34.6 days) versus the no complication group (14 days, 9.6, 19.5 days), p< 0.01. Among the non-modifiable variables, gastrostomy, tracheostomy, syndromes, and single ventricle physiology are significantly associated with longer postoperative hospital length of stay. Among the modifiable variables, deep vein thrombosis and cardiac arrest were associated with extended postoperative hospital length of stay.
Conclusions: Complications following cardiac surgery can be associated with longer hospital stay. Some complications are modifiable. Deep vein thrombosis and cardiac arrest are among the complications that were associated with longer hospital stay and offer a direct opportunity for prevention which may be reflected in better outcomes and shorter hospital stay.
