A mathematical model for predicting length of postoperative intensive care requirement following cardiac surgery in an I
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A mathematical model for predicting length of postoperative intensive care requirement following cardiac surgery in an Indian hospital Goutam Dutta1 · Ajay Naik2 · Dipa Gosai3 · Priyanko Ghosh1 Accepted: 6 September 2020 © Operational Research Society of India 2020
Abstract Intensive care unit (ICU) is a critical resource in a hospital, especially in developing countries such as India. The length of ICU stay after a cardiac surgery is an important variable for effective use of this critical resource. In this context, a predictive model can help a hospital to make optimum use of its ICU occupancy. A study was thus conducted on ICU patients and data gather over a 1-year period in a hospital in India. The critical factors for prolonged ICU stay (more than 72 h) were identified using univariate and multivariate logistic regression and a predictive index was built based on model development set. The predictive index was tested on a validation set and the mean length of ICU stay appeared to increase with an increase in the risk score. In addition, the risk score was tested in case of mortality. Efficient use of the ICU facility is possible with the help of this predictive index. Keywords Health services · Medicine · Statistics · Forecasting · Regression · Developing countries
* Goutam Dutta [email protected] Ajay Naik [email protected] Dipa Gosai [email protected] Priyanko Ghosh [email protected] 1
Indian Institute of Management, Ahmedabad, India
2
CIMS Hospital, Ahmedabad, India
3
Shri K. K. Shastri Government Commerce College, Ahmedabad, India
13
Vol.:(0123456789)
OPSEARCH
1 Introduction Intensive care unit (ICU) is a critical resource for a hospital, especially in developing countries such as India. As health care expenses rise and given that charges for ICU services constitute a significant portion of the total cost of patients’ overall hospital stay, those with prolonged ICU stay need special attention. Postoperative stay (in hours) in the ICU following a cardiac surgery is an important variable for estimating the overall use of the ICU. For optimum capacity utilization of ICU in a hospital, a predictive model to obtain this information is critical for planning admission for an elective surgery or immediate postoperative care. This study develops an index, which is probably the first attempt in India. This study is based on similar studies in Canada [1] and Europe [2]. Given that no such work exists in India so far, the past studies have been extended to the Indian context. This study was undertaken in a hospital in the western part of India. Data were gathered for a 1-year period on the demographic details of patients staying in the ICU. Once patient is admitted in a hospital who require a cardiac surgery, we need to know the severity of the patient. One way is to go by the conventional wisdom of the cardiologists and alternate way is the develop a severity score based on the scientific data analysis. If such system and severity (or critically) score is available, then the patients can be
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