Effect of centre-, patient- and procedure-related factors on intensive care resource utilisation after cardiac surgery.
OBJECTIVE
To determine associations between intensive care resource utilisation and centre-, patient- and procedure-related factors.


METHODS
Prospective multicentre cohort study.


METHODS
Twenty-one European intensive care units.


METHODS
Four thousand four hundred adult patients who had undergone cardiac or thoracic aortic surgery in 21 centres.


METHODS
None (observational study).


RESULTS
Primary outcomes were duration of artificial ventilation and intensive care unit (ICU) length of stay. Exposures were centres and patient- and procedure-related factors. Both outcomes varied fourfold among centres. Median time to extubation varied from 5 to 19 h and ICU length of stay varied from 22 to 91 h. Cox regression analysis was performed to adjust risks of prolonged ventilation and ICU length of stay for patient-, procedure- and centre-related factors. Patient- and procedure-related factors were the main risk factors among individual patients, accounting for nearly two thirds of the risk of prolonged ventilation and ICU length of stay. Centre-related variation accounted for the remaining risk.


CONCLUSIONS
In European ICUs resource utilisation is highly variable after cardiac surgery. Up to two thirds more patients could be treated with current ICU resources if the most efficient strategies and structures were applied across all centres.
Lassnigg
Andrea
A
Department of Cardiothoracic and Vascular Anaesthesia and Intensive Care, General Hospital Vienna, Waehringergürtel 18-20, 1090 Vienna, Austria.
Hiesmayr
Michael J
MJ
Bauer
Peter
P
Haisjackl
Markus
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D015331:Cohort Studies; D005060:Europe; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D019616:Thoracic Surgical Procedures; D014600:Utilization Review