Frontiers in cardiovascular medicine · 2025
Risk factors of prolonged mechanical ventilation after acute type A aortic dissection surgery: a single-center retrospective study.
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Chen Guanying, Li Zhenyu, Lin Zhonglin, Su Quanlin, Ling Yun, Li Tianbao, Zhou Chengbin
Аннотация
OBJECTIVE: To identify the risk factors of prolonged mechanical ventilation after acute type A aortic dissection (ATAAD) surgery.
METHODS: 466 patients undergoing ATAAD surgery from 2016.01 to 2021.01were studied retrospectively. Risk factors of delayed extubation (>48 h of ventilation) were identified using univariate and multivariate logistic regression. LASSO regression was used for variable selection. The ICU stay, hospital stay, complications, and 30-day mortality were analyzed.
RESULTS: Among the patients, 72% experienced delayed extubation. Risk factors included age (OR 1.042, 95% CI 1.005-1.083, P = 0.031), postoperative serum creatinine (Scr, OR 1.006, 95% CI 1.003-1.010, P < 0.001), and acute lung injury (ALI, OR 5.725, 95% CI 2.777-12.148, P < 0.001). Delayed extubation was associated with increased ICU stays, hospital stays, and complications, including MODS and higher mortality.
CONCLUSIONS: Age, postoperative serum creatinine, and acute lung injury are significant risk factors for prolonged ventilation. Early identification and management of these factors may improve postoperative outcomes.
METHODS: 466 patients undergoing ATAAD surgery from 2016.01 to 2021.01were studied retrospectively. Risk factors of delayed extubation (>48 h of ventilation) were identified using univariate and multivariate logistic regression. LASSO regression was used for variable selection. The ICU stay, hospital stay, complications, and 30-day mortality were analyzed.
RESULTS: Among the patients, 72% experienced delayed extubation. Risk factors included age (OR 1.042, 95% CI 1.005-1.083, P = 0.031), postoperative serum creatinine (Scr, OR 1.006, 95% CI 1.003-1.010, P < 0.001), and acute lung injury (ALI, OR 5.725, 95% CI 2.777-12.148, P < 0.001). Delayed extubation was associated with increased ICU stays, hospital stays, and complications, including MODS and higher mortality.
CONCLUSIONS: Age, postoperative serum creatinine, and acute lung injury are significant risk factors for prolonged ventilation. Early identification and management of these factors may improve postoperative outcomes.