Predictors for prolonged stay in the intensive care unit after surgery for acute aortic dissection type A

Objective: The goal of this study was to identify predictors of prolonged stay in the intensive care unit (ICU) in patients undergoing surgery for acute aortic dissection type A. Methods: A total of 202 patients who underwent surgery for acute aortic dissection type A in our hospital from May 2009 to May 2016 were divided into two groups based on their duration of stay in the ICU. Prolonged length of ICU stay was defined as 5 days or more in the ICU postoperatively. There were 167 patients with length of ICU stay less than 5 days, and 35 patients with length of ICU stay 5 days or more. Univariate and multivariate analysis (logistic regression) were used to identify the predictive risk factors. Results: The mean age of patients was (56.2 +/- 10.8) years, and there were 156 men (77.2%) and 46 women (22.8%). The lengths of ICU stay were (63.5 +/- 17.2) hours and (207.2 +/- 20.5) hours respectively. Overall in-hospital mortality rates were 2.4% and 14.3% respectively. Multivariate logistic analysis showed that CPB time, occurrence of postoperative stroke, acute renal failure, and acute respiratory failure were the independent predictors for prolonged ICU stay. Conclusion: The incidence of prolonged ICU stay is high after surgery for acute aortic dissection type A. Based on above factors, more active perioperative treatment strategies should be taken for patients with these risk factors to avoid more complications, and further to shorten the ICU stay time.