ORIGINAL ARTICLE Predictors of Prolonged Length of Intensive Care Unit Stay After Stage I Palliation: A Report from the National Pediatric Cardiology Quality Improvement Collaborative Carissa M. Baker-Smith • Carolyn M. Wilhelm • Steven R. Neish • Thomas S. Klitzner • Robert H. Beekman III • John D. Kugler • Gerard R. Martin • Carole Lannon • Kathy J. Jenkins • Geoffrey L. Rosenthal Received: 10 May 2013 / Accepted: 14 September 2013 / Published online: 9 October 2013 Ó Springer Science+Business Media New York 2013 Abstract The objective of this study is to identify pre- dictors of prolonged intensive care unit (ICU) length of stay (LOS) for single ventricle patients following Stage I palliation. We hypothesize that peri-operative factors contribute to prolonged ICU stay among children with hypoplastic left heart syndrome (HLHS) and its variants. In 2008, as a part of the Joint Council on Congenital Heart Disease initiative, the National Pediatric Cardiology- Quality Improvement Collaborative established a data registry for patients with HLHS and its variants undergoing staged palliation. Between July 2008 and August 2011, 33 sites across the United States submitted discharge data essential to this analysis. Data describing the patients, their procedures, and their hospital experience were entered. LOS estimates were generated. Prolonged LOS in the ICU was defined as stay greater than or equal to 26 days (i.e., 75th percentile). Statistical analyses were carried out to identify pre-operative, operative, and post-operative pre- dictors of prolonged LOS in the ICU. The number of patients with complete discharge data was 303, and these subjects were included in the analysis. Univariate and multivariate analyses were performed. Multivariate ana- lysis revealed that lower number of enrolled participants (e.g., 1–10) per site, the presence of pre-operative acidosis, increased circulatory arrest time, the occurrence of a cen- tral line infection, and the development of respiratory insufficiency requiring re-intubation were associated with prolonged LOS in the ICU. Prolonged LOS in the ICU following Stage I palliation in patients with HLHS and HLHS variant anatomy is associated with site enrollment, circulatory arrest time, pre-operative acidosis, and some post-operative complications, including central line infec- tion and re-intubation. Further study of these associations may reveal strategies for reducing LOS in the ICU fol- lowing the Norwood and Norwood-variant surgeries. This study was conducted for the Joint Council on Congenital Heart Disease National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC). C. M. Baker-Smith (&) Á C. M. Wilhelm Á G. L. Rosenthal University of Maryland School of Medicine, Baltimore, MD, USA e-mail: cbaker-smith@peds.umaryland.edu; baker109@gmail.com C. M. Baker-Smith Á C. M. Wilhelm Á G. L. Rosenthal University of Maryland Children’s Hospital, Baltimore, MD, USA S. R. Neish University of Texas Health Science Center at San Antonio, San Antonio, TX, USA T. S. Klitzner Mattel Children’s Hospital UCLA, Los Angeles, CA, USA R. H. Beekman III Á C. Lannon Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA J. D. Kugler Children’s Hospital and Medical Center, Omaha, NB, USA G. R. Martin Children’s National Medical Center, Washington, DC, USA K. J. Jenkins Departments of Cardiology and Cardiac Surgery, Children’s Hospital Boston, Boston, MA, USA 123 Pediatr Cardiol (2014) 35:431–440 DOI 10.1007/s00246-013-0797-y