Predictors of short versus prolonged PCICU stay after primary repair of tetralogy of Fallot at a tertiary care unit, Karachi: A single-center study

Abstract

BackgroundPediatric Cardiac Intensive Care Units (PCICU) stays have been associated with adverse outcomes as documented in the literature. However, data remain scarce on the factors which influence the length of such stays in the developing world. ObjectiveTo find out predictors of short versus prolonged PCICU stay after primary repair of tetralogy of Fallot (ToF). MethodsA prospective study was conducted at the Department of Pediatric Cardiology, National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan, from March 2021 to August 2021. A total of 93 patients of any age undergoing primary ToF repair were included. Patients having a PCICU stay <48 h were labeled as short PCICU stay, while those with a PCICU stay ≥48 h were termed as prolonged PCICU stay. Multivariate binary logistic regression analysis was performed to identify factors predicting prolonged PCICU stay. ResultsOverall, the mean age was noted to be 10.75 ± 4.54 years. The mean duration of PCICU was calculated to be 74.1 ± 50.2 h (Range: 24–340 h). There were 57 (61.3%) patients with prolonged PCICU, while 36 (38.7%) had a short duration of PCICU stay. In multivariate binary logistic regression analysis, significantly low SpO2 at the time of presentation, intraoperative tricuspid regurgitation, high postoperative inotropic score, postoperative pulmonary embolism, and postoperative bleeding from a wound were found to be significant predictors of prolonged PCICU stay after primary repair of ToF. ConclusionsThe findings of this study are paramount given the identification of factors associated with the prolonged stay, which will help in the future prediction of the prognosis of treated patients.