title: Clinical predictors for prolonged intensive care unit stay in adults undergoing thoracic aortic surgery requiring deep hypothermic circulatory arrest.
abstract: OBJECTIVE
  The purpose of this study was to describe clinical predictors for prolonged length of stay in the intensive care unit (PLOS-ICU) after adult thoracic aortic surgery requiring standardized deep hypothermic circulatory arrest (DHCA); and to determine the incidence of PLOS-ICU after DHCA, univariate predictors for PLOS-ICU, and multivariate predictors for PLOS-ICU.
  
  
  METHODS
  A retrospective and observational study. PLOS-ICU was defined as longer than 5 days in the ICU.
  
  
  METHODS
  Cardiothoracic operating rooms and the ICU.
  
  
  METHODS
  All adults requiring thoracic aortic repair with DHCA INTERVENTIONS: None.
  
  
  RESULTS
  The cohort size was 144. The incidence of PLOS-ICU was 27.8%. The mortality rate was 11.1%. Univariate predictors for PLOS-ICU were age, stroke, DHCA duration, vasopressor dependence >72 hours, mediastinal re-exploration for bleeding, and renal dysfunction. Multivariate predictors for PLOS-ICU were stroke, vasopressor dependence >72 hours, and renal dysfunction.
  
  
  CONCLUSIONS
  PLOS-ICU after DHCA is common. The identified multivariate predictors merit further hypothesis-driven research to enhance perioperative protection of the brain, kidney, and cardiovascular system.
authors.affiliation: Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
authors.forename: John G
authors.initials: JG
authors.lastname: Augoustides
authors.forename: Alberto
authors.initials: A
authors.lastname: Pochettino
authors.forename: E Andrew
authors.initials: EA
authors.lastname: Ochroch
authors.forename: Doreen
authors.initials: D
authors.lastname: Cowie
authors.forename: Michael L
authors.initials: ML
authors.lastname: McGarvey
authors.forename: Justin
authors.initials: J
authors.lastname: Weiner
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Gambone
authors.forename: Dawn
authors.initials: D
authors.lastname: Pinchasik
authors.forename: Albert T
authors.initials: AT
authors.lastname: Cheung
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Bavaria
mesh_terms: D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D050792:Circulatory Arrest, Deep Hypothermia Induced; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007674:Kidney Diseases / Q000453:epidemiology / Q000628:therapy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology