Determinants of Length of Intensive Care Unit Stay After Simultaneous Aortic and Mitral Valve Replacement.

OBJECTIVES

To identify the factors affecting the duration of intensive care unit (ICU) stay in patients who underwent simultaneous aortic valve replacement (AVR) and mitral valve replacement (MVR).

DESIGN

A retrospective observational study.

SETTING

A single, tertiary referral cardiovascular center.

PARTICIPANTS

The sample included 395 consecutive patients who underwent simultaneous AVR and MVR between 2006 and 2020.

INTERVENTIONS: ICU stay times were recorded for all patients, considering the variables of preoperative, intraoperative, and ICU period.

MEASUREMENTS AND MAIN

RESULTS

Multivariable analysis was conducted within a timeframe that allows clinicians to identify determinants of ICU stay length at key stages, including before surgery, upon ICU admission, and during the ICU stay. Age was independently associated with the natural logarithm of the ICU stay length [Ln (length of ICU stay)]. At ICU admission, age, preoperative left ventricular ejection fraction, cardiopulmonary bypass time, intraoperative blood product transfusion, and intra-aortic balloon pump insertion were independently correlated with Ln (length of ICU stay). During the ICU stay, ventilation time, occurrence of atrial fibrillation, use of positive inotropic agents, and all the variables mentioned above were independently associated with Ln (length of ICU stay).

CONCLUSIONS

Age, preoperative left ventricular ejection fraction, cardiopulmonary bypass time, intraoperative blood product transfusion, intra-aortic balloon pump insertion, ventilation time, occurrence of atrial fibrillation, and positive inotropic agent usage were independent determinants of the length of ICU stay at various proposed stages in patients undergoing simultaneous AVR and MVR.