Volume 22 Issue 7
Jul.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(7): 1125-1128
LIU Haiyuan, GAO Qingyun, ZHANG Chengxin, GONG Wenhui, GE Shenglin. The risk factors of postoperative prolonged ICU stay for the patients with Stanford type A aortic dissection[J]. Chinese Journal of General Practice, 2024, 22(7): 1125-1128. doi: 10.16766/j.cnki.issn.1674-4152.003581
Citation: LIU Haiyuan, GAO Qingyun, ZHANG Chengxin, GONG Wenhui, GE Shenglin. The risk factors of postoperative prolonged ICU stay for the patients with Stanford type A aortic dissection[J]. Chinese Journal of General Practice, 2024, 22(7): 1125-1128. doi: 10.16766/j.cnki.issn.1674-4152.003581
shu

The risk factors of postoperative prolonged ICU stay for the patients with Stanford type A aortic dissection

doi: 10.16766/j.cnki.issn.1674-4152.003581

  • Department of Cardiovascular Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China

Funds:

 1908085MH241

  • Received Date: 2023-05-18
    Available Online: 2024-09-05
    Abstract
  •   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 Affiliated 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 patients 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 regression to determine the independent risk factors.  Results  Emergency surgery (P < 0.001), preoperative blood nrea nitrogen (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 postoperative 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 bypass time are the risk factors of postoperative prolonged ICU stay and compared with the regular ICU stay group, the incidences of adverse events in the prolonged ICU stay group increase significantly. Risk factors should be handled proactively to reduce ICU stay and improve clinical outcome.

     

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