CAN CLINICIAN PREDICT ICU LENGTH OF STAY FOLLOWING CARDIAC-SURGERY

Purpose: To determine whether a group of experienced clinicians can pr edict intensive care unit (ICU) length of stay (LOS) following cardiac surgery. Methods: A cohort of 265 adult patients undergoing cardiac s urgery at St. Michael's Hospital, Toronto, Ontario, between January 2, 1992, and June 26, 1992, were seen preoperatively by the clinicians p articipating in the study and ICU: length of stay was predicted based on the clinicians' preoperative assessment and/or information recorded in the patient's chart. Results: Five hundred and ten ICU length of s tay predictions were Obtained from a group of eight experienced clinic ians (anaesthetists/intensivists, cardiologists, nurses). The clinicia ns predicted the exact ICU length of stay (in days) correctly 51.2% of the time and were within +/-1 day 84.5% of the time. The clinicians c orrectly predicted short ICU stays (less than or equal to 2 days) for 87.6% of the patients who had short ICU stays but only predicted long ICU stays (>2 days) in 39.4% of the patients who had long ICU stays. C onclusions: Experienced clinicians can predict preoperatively with a c onsiderable degree of accuracy patients who will have shout ICU length s of stay following cardiac surgery. However, many patients who had lo ng ICU stays were not correctly identified preoperatively. Unidentifie d preoperative risk factors or unanticipated intraoperative/postoperat ive events may be causing these patients to have longer than expected ICU stays.