Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.
Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany.
Interact Cardiovasc Thorac Surg. 2021 Jun 28;33(1):124-130. doi: 10.1093/icvts/ivab061.
The goal of this study was to identify the risk factors for prolonged length of stay (LOS) in the intensive care unit (ICU) after a bidirectional cavopulmonary shunt (BCPS) procedure and its impact on the number of deaths.
In total, 556 patients who underwent BCPS between January 1998 and December 2019 were included in the study.
Eighteen patients died while in the ICU, and 35 died after discharge from the ICU. Reduced ventricular function was significantly associated with death during the ICU stay (P = 0.002). In patients who were discharged alive from the ICU, LOS in the ICU [hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.02-1.06; P < 0.001] and a dominant right ventricle (HR 2.41, 95% CI 1.03-6.63; P = 0.04) were independent risk factors for death. Receiver operating characteristic analysis identified a cut-off value for length of ICU stay of 19 days. Mean pulmonary artery pressure (HR 1.03, 95% CI 1.01-1.05; P = 0.04) was a significant risk factor for a prolonged ICU stay.
Prolonged LOS in the ICU with a cut-off value of 19 days after BCPS was a significant risk factor for mortality. High pulmonary artery pressure at BCPS was a significant risk factor for a prolonged ICU stay.
本研究旨在确定双向腔静脉肺动脉吻合术（BCPS）后 ICU 住院时间延长（LOS）的风险因素及其对死亡人数的影响。
本研究共纳入 1998 年 1 月至 2019 年 12 月期间接受 BCPS 的 556 例患者。
18 例患者在 ICU 期间死亡，35 例患者在离开 ICU 后死亡。左心室功能降低与 ICU 住院期间的死亡显著相关（P=0.002）。在 ICU 存活出院的患者中，ICU 住院时间（HR 1.04，95%CI 1.02-1.06；P<0.001）和右心室优势（HR 2.41，95%CI 1.03-6.63；P=0.04）是死亡的独立危险因素。受试者工作特征曲线分析确定了 ICU 住院时间的截止值为 19 天。平均肺动脉压（HR 1.03，95%CI 1.01-1.05；P=0.04）是 ICU 住院时间延长的显著危险因素。
BCPS 后 ICU 住院时间延长（截止值为 19 天）是死亡率的显著危险因素。BCPS 时肺动脉压升高是 ICU 住院时间延长的显著危险因素。
