Length of Intensive care unit stay and its associated factors following open cardiac surgery: A retrospective study at the Cardiac Center Ethiopia
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Date
2025-06
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Addis Ababa University
Abstract
Background: Prolonged ICU stay after cardiac surgery can lead to higher mortality,
increased complications and poorer long-term outcomes. They also strain hospital resources
by limiting access to operating rooms—an especially serious issue in countries with limited
cardiac surgical services. Identifying risk factors for prolonged stays can support early
detection and management of complications. Such findings can also guide improvements in
clinical care and aid in resource planning.
Objective: The purpose of this study is to determine the proportion of patients with a
prolonged ICU stay following cardiac surgery and what factors are associated with
prolongation.
Method: An institution based cross sectional study was carried out on a sample of 580 by
using retrospective data. Medical records were selected by using stratified random sampling
technique. Data were then collected by using a data abstraction form prepared from extensive
literature review. After data were collected it was cleaned and recoded and analysis started
from Descriptive statistics followed by bivariable and multivariable logistic regression
analysis. P value was set at 0.05 for significance.
Result: Prolonged ICU stay (4 days or more) occurred in 26.6% of patients following cardiac
surgery. Five independent variables were found to be associated with prolonged ICU stay
including; Preoperative atrial fibrillation (OR=2.41, 95%CI= 1.00-5.80, p=0.04), Duration of
cardiopulmonary bypass (OR=1.10, 95%CI=1.00-1.02, p=0.006), Postoperative bleeding
(OR=3.04, 95%CI=2.05-6.75, p=0.004), Postoperative AKI (OR= 17.02, 95% CI= 1.52 –
189.87, p=0.02) and other complications (OR=3.73, 95% CI= 1.42-6.48, p=0.0001).
Conclusions: This study examined why some patients stay longer in the ICU after open
cardiac surgery. It identified that 26.6% of patients had prolonged ICU stay. Several factors
such as Preoperative Atrial fibrillation, Duration of cardiopulmonary bypass, postoperative
AKI, Postoperative bleeding and other complications put patients at risk of prolonged stay.
These finding can help clinicians identify and manage high-risk patients early and improve
perioperative care which could help reduce duration of ICU stay.
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Keywords
Open cardiac surgery, Retrospective study, Cardiac Center Ethiopia, Intensive Care Unit (ICU), LMICs, Prolonged ICU stay