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. Study Design: A retrospective and observational study. PLOS-ICU was defined as longer than 5 days in the ICU. Study Setting: Cardiothoracic operating rooms and the ICU. Participants: All adults requiring thoracic aortic repair with DHCA Interventions: None. Main 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 reexploration 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. (C) 2006 Elsevier Inc. All rights reserved.