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J Cardiovasc Surg (Torino). 1995 Feb;36(1):1-11.

The use of APACHE III to evaluate ICU length of stay, resource use, and mortality after coronary artery by-pass surgery.

Author information

1
Department of Anesthesiology, George Washington University Medical Center, Washington, DC 20037, USA.

Abstract

OBJECTIVE:

To identify patient characteristics that are associated with increased ICU length of stay, resource use, and hospital mortality after coronary artery bypass surgery.

DESIGN:

Prospective, multicenter study.

SETTING:

Six tertiary care hospitals.

PARTICIPANTS:

A consecutive sample of 2,435 unselected ICU admissions following coronary artery by-pass surgery.

MATERIALS AND METHODS:

Demographic, operative characteristics and APACHE III score were collected during the first postoperative day; and APACHE III scores and therapeutic interventions during the first three postoperative days. Hospital survival and ICU length of stay were also recorded. Multivariate equations were derived and cross-validated to predict hospital mortality, ICU length of stay, and ICU resource use.

RESULTS:

Unadjusted hospital mortality rate was 3.9% (range 1.0% to 6.0%), mean ICU length of stay was 3.7 days (range 3.2 to 4.7 days), and first 3-day ICU resource use (TISS points) was 99 (range 68 to 116). The range of actual to predicted ICU length of stay varied from 0.86 to 1.26; and resource use from 0.71 to 1.16.

CONCLUSIONS:

A limited number of operative characteristics, the post-operative acute physiology score (APS) of APACHE III and patient demographic data can predict hospital death rate, ICU length of stay, and resource use immediately following coronary by-pass surgery. These estimates may compliment assessments based on pre-operative risk factors in order to more precisely evaluate and improve the efficacy and efficiency of cardiovascular surgery.

PMID:
7721919
[Indexed for MEDLINE]

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