Effect of sleep disorder on intensive care unit stay in patients undergoing cardiac surgery:a retrospective cohort study based on the Medical Information Mart for Intensive Care IV database
Objective To explore the association between sleep disorders and prolonged intensive care unit(ICU)stay in pa-tients undergoing cardiac surgery.Methods Patients who underwent cardiac surgery before admission to the ICU from 2008 to 2019 in the Medical Information Mart for Intensive Care Ⅳ(MIMIC-Ⅳ)database were selected.Based on the presence of sleep disorders,the patients were divided into two groups:a normal sleep group and a sleep disorder group.Their ICU data,including baseline vari-ables,comorbidities,vital signs,and laboratory test results,were collected.Univariate and multivariate logistic regression analysis were used to determine the independent risk factors for prolonged ICU stay,and the correlation between sleep disorders and prolonged ICU stay and delirium was analyzed.Results A total of 6 319 post-cardiac surgery patients were included.Compared with the normal sleep group,patients in the sleep disorder group showed an increased proportion of chronic lung disease and liver disease(all P＜0.05),while the differences in other baseline indicators were not statistically significant(all P＞0.05).The incidence of prolonged ICU stay was significantly higher in the sleep disorder group than in the normal sleep group(P＜0.05),while the incidence of delirium was not signifi-cantly different between the two groups(P＞0.05).Multivariate logistic regression analysis indicated that female gender,congestive heart failure,kidney disease,peripheral vascular disease,mean blood pressure,respiratory rate,mean corpuscular volume,red cell dis-tribution width,blood urea nitrogen,activated partial thromboplastin time,lactate,delirium,and sleep disorders were independent fac-tors for prolonged ICU stay in cardiac surgery patients.Sleep disorder was significantly associated with prolonged ICU stay[hazard ratio(HR)1.42(95％confidence interval(CI)1.03,1.96),P=0.034],and this association remained statistically significant after adjusting for age,gender,race,and comorbidities[HR 1.48(95％CI 1.06,2.08),P＜0.05].However,sleep disorders did not increase the risk of deliri-um in these patients(P＞0.05).Conclusion Sleep disorder is a predictor of prolonged ICU stay of post-cardiac surgery patients.
Sleep disorderCardiac surgery proceduresIntensive care unitLength of stayDelirium
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