Analysis of clinical features and risk factors of re-admission to ICU after cardiac surgery
CHEN Weichi1* ZHAO Yanxue2* LIU Xinpei2 LIU Jianzhou2 MIAO Qi2 ZHENG Jun2 ZHANG Chaoji2
1.Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China; 2.Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
Abstract：Objective To summarize the clinical characteristics of patients re-admission to the intensive care unit (ICU) after cardiac surgery and to evaluate the risk factors for re-admission to the ICU. Methods A total of 2 722 patients admitted to the Department of Cardiac Surgery in Peking Union Medical College Hospital from January 2016 to December 2022 were admitted to ICU after open heart surgery, 2 102 patients were admitted to ICU after surgery, of which 2 083 patients were admitted to ICU only once and 19 patients were re-admitted to ICU. The clinical characteristics of re-admission to ICU were analyzed, and 57 patients who were admitted to ICU only once were selected as the control group according to the ratio of 1∶3 and were similar in age, gender, and admission time to the study group. The risk factors of re-admission to ICU were explored by conditional logistic regression. Results Respiratory failure was the most important reason for re-admission to ICU after cardiac surgery. There were significant differences in cardiac function grade, left ventricular ejection fraction, cardiopulmonary bypass time, first ICU stay time, and continuous renal replacement therapy between the two groups (P＜0.05). Univariate conditional logistic analysis showed that preoperative cardiac function grade, left ventricular ejection fraction, intraoperative CPB time, first ICU stay time, continuous renal replacement therapy were related to the occurrence of postoperative ICU re-admission (P＜0.05). Multivariate logistic regression showed that CRRT (OR:12.986, 95%CI:2.839-59.395, P=0.001) was an independent risk factor for postoperative re-admission to ICU. Conclusion CRRT after open heart surgery is a risk factor for re-admission to ICU after open heart surgery, which can help doctors identify high-risk patients in time and promote diagnosis and treatment.
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2023, Vol. 20 
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