Preoperative and intraoperative risk factors for prolonged intensive care unit stay after aortic arch surgery.
OBJECTIVE
The present study was performed to evaluate preoperative and intraoperative risk factors for prolonged intensive care unit (ICU) stay after aortic arch surgery.


METHODS
A retrospective study. Prolonged ICU stay was defined as >5 days (120 hours).


METHODS
Cardiovascular operating rooms and the ICU.


METHODS
Adults requiring aortic arch surgery with deep hypothermic circulatory arrest plus antegrade selective cerebral perfusion.


METHODS
None.


RESULTS
After 11 patients who underwent 1-stage total or subtotal aortic replacement were excluded, 298 patients were enrolled in the study. The average age of patients was 44.9 +/- 10.7 years with male predominance (74.8%). Sixty-one patients (20.5%) stayed longer than 5 days in the ICU. Univariate analyses found age, body mass index, New York Heart Association classification, preoperative serum creatinine, creatinine clearance, emergency, inotropes, cardiopulmonary bypass time, myocardial ischemia time, and fresh-frozen plasma transfused intraoperatively were significantly associated with prolonged ICU stay (p < 0.05). Independent risk factors for prolonged ICU stay were found to be New York Heart Association classification (class III and IV), emergency, inotropes used intraoperatively, and prolonged cardiopulmonary bypass time (p < 0.05).


CONCLUSIONS
The authors identified 4 preoperative and intraoperative risk factors for prolonged ICU stay. This is helpful to identify patients with increased risk for prolonged ICU stay, implement specific strategies, and allocate medical resources.
Lei
Qian
Q
Department of Anesthesiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Chen
Lei
L
Jin
Mu
M
Ji
Hongwen
H
Yu
Qinjun
Q
Cheng
Weiping
W
Li
Lihuan
L
D000328:Adult; D001013:Aorta, Thoracic / Q000601:surgery*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007432:Intraoperative Period; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000601:surgery; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome