Abstract

Background: Determining main predictors of prolonged intensive care unit (ICU) stay in patients undergoing heart valve surgeries is used to target high risk group to improve resource utilization and efficiency of ICU care and outcome. The present study aimed to assess clinical status of patients with rheumatologic valvular heart diseases who were candidate for valvular surgeries and also to determine main correlates of prolonged ICU stay in these patients.

Methods: The records of 688 patients with rheumatic heart diseases that underwent different types of heart valve surgeries at the Tehran Heart Center were retrospectively reviewed. The patients were assigned to two groups that experienced prolonged ICU stay (defined as the length of ICU stay longer than 6 days) or with ICU hospitalizations less than 6 days.

Results: The rate of prolonged ICU stay was found to be 10%. With respect to main determinants of prolonged ICU stay and using the stepwise logistic regression modeling, advanced age (OR = 1.237, p = 0.001), the presence of severe pulmonary insufficiency (OR = 3.168, p = 0.022), aortic stenosis (OR = 1.977, p = 0.021), history of brain stroke (OR = 2.410, p = 0.015), and tricuspid replacement procedure (OR = 8.047, p < 0.001) were main correlates of prolonged ICU stay. Moreover, atrial fibrillation correction could effectively shorten ICU stay (OR = 0.264, p = 0.012).

Conclusion: About 10% of patients undergo heart valve surgeries experience prolonged ICU stay that can be well predicted by some factors including advanced age, severe pulmonary insufficiency, aortic stenosis, brain stroke, and tricuspid replacement surgery. Atrial fibrillation correction may shorten ICU stay in these patients.

Keywords: Rheumatologic Valvular Heart Disease; Valvular Surgery; Intensive Care Unit; Prediction

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