title: Determinants of mortality in patients requiring prolonged intensive care unit stay after elective isolated on-pump coronary artery bypass grafting surgery.
abstract: BACKGROUND
  In up to 36% of patients undergoing cardiac surgery prolonged intensive care unit stay may be necessary. Mortality rates of these patients range from 11% to 94%, causing enormous clinical and ethical issues.
  
  
  OBJECTIVE
  To identify preoperative, perioperative and postoperative risk factors of mortality in patients with prolonged intensive care unit stay after elective, isolated on-pump coronary artery bypass grafting surgery.
  
  
  METHODS
  Clinical data of 137 patients who underwent an elective, isolated on-pump coronary artery bypass grafting operation, and had an intensive care unit stay of > or = 3 days were retrospectively evaluated. Survivors and non-survivors were compared with regard to preoperative, perioperative and postoperative characteristics to identify the risk factors for mortality.
  
  
  RESULTS
  Multivariate analysis demonstrated that diabetes mellitus (OR = 3.62, 95% CI 1.07-12.26, p = 0.039), postoperative renal dysfunction (OR = 3.86, 95% CI 1.26-11.75, p = 0.018), postoperative intra-aortic balloon pump use (OR = 3.47; 95% CI 1.01-13.24, p = 0.048), prolonged intubation (OR = 3.90, 95% CI 1.19-12.69, p = 0.024) and re-intubation (OR = 14.83, 95% CI 4.35-50.55, p = 0.001) were significant and independent risk factors of mortality.
  
  
  CONCLUSIONS
  The present study found that the preoperative presence of diabetes mellitus, and postoperative multiorgan failure syndrome decreased the probability of survival in patients with prolonged intensive care unit stay after elective isolated on-pump coronary artery bypass surgery.
authors.affiliation: Ozel Avrupa Safak Hastanesi, Kucukkoy yolu hamam sok., Turkey. htekumit@yahoo.com
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Tekumit
authors.forename: Kemal
authors.initials: K
authors.lastname: Uzun
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Cenal
authors.forename: Cenk
authors.initials: C
authors.lastname: Tataroglu
authors.forename: Adil
authors.initials: A
authors.lastname: Polat
authors.forename: Esat
authors.initials: E
authors.lastname: Akinci
mesh_terms: D000368:Aged; D015984:Causality; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000401:mortality*; D003422:Critical Care / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000453:epidemiology; D017558:Elective Surgical Procedures / Q000401:mortality*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007674:Kidney Diseases / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014421:Turkey / Q000453:epidemiology