జీవశాస్త్రం మరియు వైద్యం

నైరూప్య

Factors of Prolonged Intensive Care Unit Stay After Surgery in Patients with Type A Acute Aortic Dissection

Mohammed Firoj Khan, Xian en Fa and Hai Bin Yu

Objective: To identify the risk factors of prolonged Intensive Care Unit stay after surgery in patients with the type A acute aortic dissection. Methods: Retrospective analysis of 80 patients, 54 males (67.5%) and 26 females (32.5%) who underwent surgery for the treatment of Stanford type A acute aortic dissection in the cardiovascular department of 2nd affiliated hospital of Zhengzhou university through December 2014 to July 2016 were done. The mean age of the patients was 48.9 ± 12.5 years. The patients were divided into two groups, group A, prolonged (n=13) and group B, nonprolonged (n=67) based on the duration of ICU stay time either above or below 5 days. Univariate and multivariate analysis were done to find out the predictive risk factors. Results: The mean length of ICU stay time was 206.9 ± 25.4 hours in group A and 63.2 ± 17.4 hours in group B respectively. Mortality rate was 15.4% in group A and 3.0% in group B while overall mortality was 5%. ICU stay time was significantly influenced by the following factors; age (P=0.013), EuroSCORE (P=0.017), preoperative D- dimer (P=0.006], Deep hypothermic circulatory arrest (P=0.026), postoperative stroke (P=0.016), CPB time (P=0.002), postoperative stroke (P=0.009), postoperative acute respiratory failure (P=0.041) and postoperative acute renal failure (P=0.002). Conclusion: Age, Euro SCORE, preoperative D- dimer level, CPB time, Deep hypothermic circulatory arrest, postoperative stroke, postoperative acute respiratory failure and postoperative acute renal failure are independent risk factors of prolonged ICU stay in the patients after operation for Stanford type A acute aortic dissection.