Clinical predictors for prolonged intensive care unit stay in adults undergoing thoracic aortic surgery requiring deep hypothermic circulatory arrest.
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.
Augoustides
John G
JG
Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
Pochettino
Alberto
A
Ochroch
E Andrew
EA
Cowie
Doreen
D
McGarvey
Michael L
ML
Weiner
Justin
J
Gambone
Andrew J
AJ
Pinchasik
Dawn
D
Cheung
Albert T
AT
Bavaria
Joseph E
JE
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