Impact of Intensive Care Unit and Acute Care Unit Length of Stay on Total Length of Stay Following Congenital Heart Surgery: A Joint PC4 and PAC3 Multicenter Analysis

Introduction: Length of stay (LOS), an important quality metric and cost driver, is known to vary widely across hospitals following congenital heart surgery. Whether this variability is influenced more by intensive care unit (ICU) or acute care unit (ACU, or general inpatient ward) LOS remains unclear. We evaluated the relationship between ICU, ACU, and total LOS, and the influence of ACU characteristics. Methods: Congenital heart surgery hospitalizations within the Pediatric Cardiac Critical Care Consortium (PC4) registry (8/14-2/18) were included. Post-op total, ICU, and ACU LOS were modeled, adjusting for differences in case-mix across hospitals. Observed-to-expected (O/E) ratios and 95% confidence intervals (CI) were derived for each hospital; an O/E and 95% CI entirely below or above 1 were classified as having statistically shorter or longer-than-expected LOS, respectively. PC4 hospitals participating in the Pediatric Acute Care Cardiology Collaborative (PAC3) were also surveyed on ACU practices/res...