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PREDICTION TOOL FOR CONGENITAL HEART SURGERY LENGTH OF STAY
594 JACC March 21, 2017 Volume 69, Issue 11
Congenital Heart Disease PREDICTION TOOL FOR CONGENITAL HEART SURGERY LENGTH OF STAY Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: Congenital Heart Disease: Progress in Pediatric Heart Surgery Abstract Category: 10. Congenital Heart Disease: Pediatric Presentation Number: 1101-016 Authors: Matthew DiOrio, Catherine Allan, Ravi Thiagarajan, Kimberlee Gauvreau, Meena Nathan, Derek Mathieu, Aditya Kaza, James Dinardo, Jean Connor, John Mayer, Puja Banka, Jason Thornton, John Triedman, Lisa Bergersen, Boston Children’s Hospital, Boston, MA, USA Background: In response to increasing demand to optimize hospital resource use, we developed a methodology to predict extended length of stay (LOS) in the cardiac intensive care unit (CICU) following surgery for congenital heart disease.
Methods: Patients undergoing congenital heart surgery at Boston Children’s Hospital between 2007 and 2014 were identified. Clinical variables and established Surgical LOS Categories (SLC) were prospectively recorded based on surgical intervention performed. A model was built to predict the outcome post-operative CICU LOS > 7 days. Results: The cohort included 6,242 cases categorized into 5 Surgical LOS categories with a C statistic of 0.77 for the outcome CICU LOS > 7 days. Explanatory value increased with inclusion of patient preoperative status as determined by age, ventilator dependence, and admission status (C statistic = 0.84, Table 1). Additional patient and procedural characteristics did not significantly increase model prediction.
Conclusions: Using a model comprised of basic patient characteristics, we have developed a robust method for predicting if a patient will remain in the CICU longer than seven days. Table 1. Predicted probability matrix of post-operative ICU LOS > 7 days Surgical Length Category Preoperative Status (age / vent status / same day admit) 1 2 3 ≥ 30 day / no vent / SDA 0.028 0.051 0.088 ≥ 30 day / no vent / not SDA 0.094 0.160 0.256 < 30 day / no vent 0.092 0.156 0.250 < 30 day / vent 0.146 0.240 0.362 ≥ 30 day / vent 0.364 0.512 0.654
4 0.160 0.402 0.396 0.527 0.788
5 0.211 0.487 0.480 0.611 0.840
Congenital Heart Disease PREDICTION TOOL FOR CONGENITAL HEART SURGERY LENGTH OF STAY Poster Contributions Poster Hall, Hall C Friday, March 17, 2017, 10:00 a.m.-10:45 a.m. Session Title: Congenital Heart Disease: Progress in Pediatric Heart Surgery Abstract Category: 10. Congenital Heart Disease: Pediatric Presentation Number: 1101-016 Authors: Matthew DiOrio, Catherine Allan, Ravi Thiagarajan, Kimberlee Gauvreau, Meena Nathan, Derek Mathieu, Aditya Kaza, James Dinardo, Jean Connor, John Mayer, Puja Banka, Jason Thornton, John Triedman, Lisa Bergersen, Boston Children’s Hospital, Boston, MA, USA Background: In response to increasing demand to optimize hospital resource use, we developed a methodology to predict extended length of stay (LOS) in the cardiac intensive care unit (CICU) following surgery for congenital heart disease.
Methods: Patients undergoing congenital heart surgery at Boston Children’s Hospital between 2007 and 2014 were identified. Clinical variables and established Surgical LOS Categories (SLC) were prospectively recorded based on surgical intervention performed. A model was built to predict the outcome post-operative CICU LOS > 7 days. Results: The cohort included 6,242 cases categorized into 5 Surgical LOS categories with a C statistic of 0.77 for the outcome CICU LOS > 7 days. Explanatory value increased with inclusion of patient preoperative status as determined by age, ventilator dependence, and admission status (C statistic = 0.84, Table 1). Additional patient and procedural characteristics did not significantly increase model prediction.
Conclusions: Using a model comprised of basic patient characteristics, we have developed a robust method for predicting if a patient will remain in the CICU longer than seven days. Table 1. Predicted probability matrix of post-operative ICU LOS > 7 days Surgical Length Category Preoperative Status (age / vent status / same day admit) 1 2 3 ≥ 30 day / no vent / SDA 0.028 0.051 0.088 ≥ 30 day / no vent / not SDA 0.094 0.160 0.256 < 30 day / no vent 0.092 0.156 0.250 < 30 day / vent 0.146 0.240 0.362 ≥ 30 day / vent 0.364 0.512 0.654
4 0.160 0.402 0.396 0.527 0.788
5 0.211 0.487 0.480 0.611 0.840