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Predictors of Prolonged Intensive Care Unit Length of Stay among Surgical Patients: A Scoping Review

Amal Kaki, Asmaa Hamdi Khalil and Elham Nagshabandi

Objective: This review aims to identify relevant studies related to predictors of prolonged intensive care unit length of stay among surgical patients in the literature.

Method: The search strategy for this review identified published literature in the following databases: PubMed, MEDLINE, CINAHL, and other sources (Google scholar), using appropriate search terms. The search was limited to full-text journal articles published in the English language from 2015 to 2021 and articles that studied the predictors of prolonged Intensive Care Unit-Length of Stay (ICU-LOS) among surgical patients. It excluded articles that were not peer-reviewed, qualitative studies, unpublished articles, and conference papers.

Results: Overall, twenty-five studies met the inclusion criteria. Of the twenty-five studies, nineteen had a retrospective design, and three used an observational cohort design. Three studies had a prospective study design. However, two studies did not mention which design was used. Several themes were identified from the review, including preoperative factors associated with prolonged ICU-LOS among surgical patients, intraoperative and postoperative factors associated with prolonged ICU-LOS among surgical patients, the impact of intubation and use of mechanical ventilators on ICU-LOS, and outcomes of prolonged ICU-LOS.

Conclusion: Most of the reviewed studies involved the postoperative factors that contribute to increasing ICU-LOS, such as bleeding, intubation, sepsis and use of a mechanical ventilator. Few studies were found related to pre and intraoperative predictors. Thus, having nurses who can detect the predictors that may prolong ICU-LOS and provide appropriate management as early as possible is crucial.