Impact of Operating Room Procedure Duration on Postoperative Outcomes in Cardiac Surgery: A Retrospective Cohort Analysis from a Tertiary Cardiac Care Center in Pakistan

Abstract

Objectives: To investigate the relationship between the duration of operating room procedures, including cardiopulmonary bypass (CPB) time, and postoperative in-hospital outcomes following cardiac surgery, focusing on length of mechanical ventilation, surgical intensive care unit (SICU) stay, and in-hospital mortality. Methodology: A retrospective cohort study was conducted at the Peshawar Institute of Cardiology (PIC) between January and September 2024, involving 166 adult patients who underwent elective cardiac surgery with CPB. Data were extracted from the hospital’s Health Management Information System (HMIS). Operating room and CPB durations were categorized into defined time intervals. Postoperative outcomes, including mechanical ventilation hours, SICU stay, and mortality, were analyzed using the Mann–Whitney U test, with a p-value of <0.05 considered significant. Results: The mean age of patients was 54.66 ± 12.29 years, with males comprising 73.5% of the cohort. The average operating room duration was 393.7 ± 63.8 minutes, and the mean CPB time was 103.5 ± 28.0 minutes. CABG was the most common procedure (74.7%). Prolonged surgical duration was significantly associated with longer SICU stays (p = 0.011), though not with mechanical ventilation (p = 0.738) or mortality (p = 0.907). CPB duration showed no significant association with postoperative outcomes (p > 0.05). The overall in-hospital mortality rate was 0.6%. Conclusion: Longer operating room durations were associated with extended SICU stays but not with increased mechanical ventilation time or mortality. These findings emphasize the importance of optimizing intraoperative efficiency to improve patient recovery and resource utilization in cardiac surgery.