Correlation analysis of tricuspid regurgitation and prolongation of intensive care unit length of stay in patients after non-cardiac surgery and nomogram construction

Wang Jingyi; Liu Yifan; Li Wenxiong; Zhang Jin

doi:10.3760/j.issn.1673-4777.2025.06.004

Abstract：Objective To explore the correlation between tricuspid regurgitation and the prolongation of the intensive care unit length of stay(ICU-LOS)in critically ill patients after non-cardiac surgery,and to construct the nomogram predictive model of ICU-LOS prolongation.Methods Critically ill patients who were transferred to ICU immediately after non-cardiac surgery in Beijing Chao-yang Hospital,Capital Medical University from January 2019 to December 2021 were selected.The patients' baseline data,preoperative echocardiography,preoperative laboratory indicators,operation duration,intraoperative blood loss,and acute physiology and chronic health score system Ⅱ(APACHE Ⅱ)score at ICU admission were collected.The primary endpoint was the incidence of prolonged ICU-LOS(＞72 h).Cox regression was used to analyze the relationship between tricuspid regurgitation and ICU-LOS prolongation and the clinical risk factors affecting ICU-LOS prolongation,and a nomogram prediction model was constructed based on tricuspid regurgitation combined with other clinical risk factors.Results A total of 2 416 adult patients admitted to ICU immediately after non-cardiac surgery were included in this study.Six hundred and six patients(25.1％)were complicated with tricuspid regurgitation before surgery,including 536 patients(88.4％)with mild or less regurgitation and 70 patients(11.6％)with moderate or more regurgitation.Multivariate Cox regression analysis showed that age,segmental wall motion abnormalities,tricuspid regurgitation,operation time,intraoperative blood loss and APACHE Ⅱ score were independent risk factors for prolonged ICU-LOS in critically ill patients after non-cardiac surgery(all P＜0.05).A nomogram for predicting ICU-LOS prolongation was constructed based on the above risk factors,and the area under the receiver operating characteristic curve was 0.822(95％confidence interval:0.799-0.844,P＜0.001).Conclusion Tricuspid regurgitation is an independent risk factor for ICU-LOS prolongation in critically ill patients after non-cardiac surgery.The nomogram model based on tricuspid regurgitation combined with other clinical indicators(age,segmental wall motion abnormalities,operation duration,intraoperative blood loss,and APACHE Ⅱ score)has good predictive ability for ICU-LOS prolongation in critically ill patients after non-cardiac surgery.