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 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.