Objective To explore the risk factors of postoperative prolonged ICU stay for the patients with Stanford type A aortic dissection and assessed the influence on the clinical outcome due to prolonged ICU stay.Methods A total of 100 patients with Stanford type A aortic dissection admitted in the Department of Cardiovascular Surgery,the First Affilia-ted Hospital of Anhui Medical University from December 2018 to September 2022 were enrolled as subjects.The clinical material of all patients was collected and analyzed retrospectively.The preoperative and intraoperative material for the pa-tients in two groups were tested using univariate analysis,regular ICU stay(＜7 days,65 cases)and prolonged ICU stay(≥7 days,35 cases)based on the period in ICU and then the obtained significant variates were tested using logistic re-gression to determine the independent risk factors.Results Emergency surgery(P＜0.001),preoperative blood nrea ni-trogen(P=0.001),preoperative glucose(P=0.048),cardiopulmonary bypass time(P=0.009)and operating time(P=0.010)were considered as significant variates using univariate analysis.Further,based on the findings of logistic regression,emergency surgery(OR=0.192,P=0.003),preoperative blood urea nitrogen(OR=0.775,P=0.013)and cardiopulmonary bypass time(OR=0.988,P=0.014)were identified as the independent risk factors of postopera-tive prolonged ICU stay.In the predictive model,the combination of all three factors(AUC=0.810)was more effective than any single factor(AUC=0.308,0.288 and 0.340).For the clinical outcome assessment,there were significance on the disability of limbs(P＜0.001),severe organic injury(P＜0.001),tracheotomy(P＜0.001),extubation within 72 h after surgery(P＜0.001),awaking within 12 h after surgery(P＜0.001),discharging(P＜0.001)and hospital stay(P=0.037)in two groups.Conclusion Emergency surgery,preoperative urea nitrogen and cardiopulmonary by-pass time are the risk factors of postoperative prolonged ICU stay and compared with the regular ICU stay group,the inci-dences of adverse events in the prolonged ICU stay group increase significantly.Risk factors should be handled proactive-ly to reduce ICU stay and improve clinical outcome.
Stanford type A aortic dissectionProlonged ICU stayRisk factors
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