DETERMINANTS OF LENGTH OF STAY AFTER CORONARY-ARTERY BYPASS GRAFT-SURGERY

Background Rising healthcare costs have prompted limitations in the le ngth of stay (LOS) for patients undergoing coronary artery bypass graf t surgery (CABG). Because not all patients are candidates for early di scharge, in the present study our aim was to determine factors that pr olong LOS. Methods and Results In 194 consecutive patients undergoing CABG procedures, LOS was >7 days in 37%. Stepwise multiple regression procedures and chi(2) testing were used to determine what factors prol onged LOS for >7 days. Preoperative factors that significantly (P<.05) prolonged LOS included repeat CABG, CABG plus valve surgery, congesti ve heart failure, preoperative coronary care unit stay, renal failure, and insulin-dependent diabetes mellitus. Patients with at least one r isk factor had a significantly higher incidence of LOS of >7 days (47% versus 17%; P<.001). Significant (P<.05) postoperative factors prolon ging LOS included arrhythmias, respiratory insufficiency, pneumonia, a nd wound infection. Of patients with at least one risk factor, 83% had LOS of >7 days (P<.001). Conclusions The presence of certain preopera tive and postoperative risk factors can be predicted to prolong LOS af ter CABG surgery. This should be taken into consideration when definin g reimbursement policies.