Zartash Syeda Huma, Saleem Sidra, Rasool Zain, Mansur Abeera
Syeda Huma Zartash (MBBS, MRCP), Director Coronary Care Unit, Doctors Hospital & Medical Center, Lahore Pakistan.
Sidra Saleem (M.B.B.S, FCPS, MRCP), Research Assistant Coronary Care Unit and Nephrology Department. Doctors Hospital & Medical Center, Lahore Pakistan.
Pak J Med Sci. 2023 Mar-Apr;39(2):544-548. doi: 10.12669/pjms.39.2.6735.
Prolonged intensive care unit stay not only increases hospital cost but it also prevents hospital equipment to be used by other patients who need them. The aim of this study was to identify factors that affect the duration of intensive care unit stay in post coronary artery bypass grafting patients with chronic kidney disease.
This is a single centered observational prospective study done on 191 post coronary artery bypass grafting patients from June 2018 to April 2019 at Cardiac Surgery Unit of Doctor's hospital and medical center, Lahore, Pakistan. Patients above 18 years with and without chronic kidney disease were included.
Mean age of the patients was 57.83 years (± 9.862 SD. Logistic regression analysis shows that patients with post op arrhythmias had the strongest positive association with prolonged intensive care unit stay (OR:11; p value :<0.01), followed by recent myocardial infarction less than 90 days pre coronary artery bypass grafting (OR:5.93; p value:<0.01), shock (OR:3.93;p value:0.04) and acute kidney injury (OR :2.08;p value:0.04). 37.5% chronic kidney disease patients with recent myocardial infarction less than 90 days pre coronary artery bypass grafting and 51.4% patients of chronic kidney disease found with acute kidney injury, showed significant association with p values less than 0.05.
Post op arrhythmias, recent myocardial infarction, shock and acute kidney injury are independent risk factors causing prolonged intensive care unit stay in post coronary artery bypass grafting patients.
重症监护病房（ICU）住院时间延长不仅会增加医院成本，还会导致医院设备无法供其他有需要的患者使用。本研究的目的是确定影响冠状动脉旁路移植术后慢性肾病患者在ICU住院时间的因素。
这是一项单中心观察性前瞻性研究，于2018年6月至2019年4月在巴基斯坦拉合尔医生医院和医疗中心心脏外科对191例冠状动脉旁路移植术后患者进行。纳入了年龄在18岁以上、患有或未患有慢性肾病的患者。
患者的平均年龄为57.83岁（标准差±9.862）。逻辑回归分析表明，术后心律失常患者与ICU住院时间延长的正相关性最强（比值比：11；p值：<0.01），其次是冠状动脉旁路移植术前不到90天发生的近期心肌梗死（比值比：5.93；p值：<0.01）、休克（比值比：3.93；p值：0.04）和急性肾损伤（比值比：2.08；p值：0.04）。37.5%冠状动脉旁路移植术前不到90天发生近期心肌梗死的慢性肾病患者以及51.4%发生急性肾损伤的慢性肾病患者，其p值均小于0.05，显示出显著相关性。
术后心律失常、近期心肌梗死、休克和急性肾损伤是导致冠状动脉旁路移植术后患者在ICU住院时间延长的独立危险因素。
