• Konstantinos Giakoumidakis, George I Baltopoulos, Christos Charitos, Evridiki Patelarou, Petros Galanis, and Hero Brokalaki.
• Cardiac Surgery Intensive Care Unit, Evangelismos General Hospital of Athens, Athens, Greece. kongiakoumidakis@gmail.com
• Nurs Crit Care. 2011 Sep 1;16(5):243-51.

Aims And ObjectivesTo identify the factors that might affect the length of stay in the intensive care unit (ICU-LOS) among cardiac surgery patients.BackgroundICU-LOS forms an important factor for assessing the effectiveness of the provided nursing care. A number of factors can be accused for increasing patient hospitalization. The nursing workload (NWL), among others, was found to play a significant role as it is closely associated with the quality of care.DesignAn observational cohort study among 313 consecutive patients who were admitted to the cardiac surgery intensive care unit of a general, tertiary hospital of Athens, Greece from November 2008 to November 2009.MethodsData collection was performed by using a short questionnaire (for basic demographic information) and two instruments, the Nursing Activities Score (NAS) and the logistic EuroSCORE, for assessing the NWL and the perioperative risk for each patient respectively.ResultsICU-LOS of more than 2 days increased with age and was more common among females (p < 0.001 and p = 0.02, respectively). Multivariate logistic regression analysis revealed a positive association between increased perioperative risk and the increased ICU-LOS [odd ratio (OR) 1.9, 95% confidence interval (CI) 1.0-3.5, p = 0.04], while patients with a first day NAS of more than 61.6% had an almost 5.2 times greater probability to stay in the cardiac surgery unit for more than 2 days (OR 5.2, 95% CI 3.0-8.8, p < 0.001).ConclusionsIncreased level of NWL and patient perioperative risk are closely associated with increased ICU-LOS.Relevance To Clinical PracticeThe correlation between patient perioperative risk and ICU-LOS encourages the early identification of high-risk patients for prolonged hospitalization. Furthermore, the relationship between NWL and ICU-LOS allows the early identification of these patients with the use of an independent nursing tool.© 2011 The Authors. Nursing in Critical Care © 2011 British Association of Critical Care Nurses.

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