Surgical Procedure Assessment score predicts ICU length of stay in cardiac surgical patients

Introduction

With a high volume of cardiac surgical patients, effective allocation and prediction of the use of limited ICU beds is essential. We developed the Surgical Procedure Assessment (SPA) score (see Table 1) as a simple preoperative tool to assess ICU needs for cardiac surgical patients. After a pilot study (182 patients), we applied this score to a larger prospective cohort to test its association with ICU length of stay (LOS).

Table 1

Methods

SPA scores were assigned preoperatively to all patients undergoing cardiac surgery during 2002 at a single center. All patients were admitted to either the cardiothoracic or surgical ICU following surgery and data were collected prospectively during the hospitalization.

Results

A total of 1201 patients were enrolled. The mean age was 64 years (SD ± 14.2) and 66% were male. There was an increase in median length of stay for each step increase in the SPA score (1A: 1.1 days; 1B: 1.3 days; 2A: 1.6 days, 2B: 3.0 days, 3: 9.6 days), which was statistically significant (P < 0.01 Cuzick's nonparametric test for trend) (see Fig. 1).

Figure 1

Conclusion

There is a strong correlation between the preoperatively assigned SPA score and ICU LOS for patients undergoing cardiac surgery. This simple, easily assigned score may provide an efficient method for improving cardiac surgery scheduling and allocation of ICU resources.