Predictive risk factors for prolonged mechanical ventilation after surgery for stanford type A acute aortic dissection / 中华胸心血管外科杂志

ABSTRACT

To identify the predictors of prolonged mechanical ventilation in patients undergoing surgery for stanford type A acute aortic dissection. Methods 202 patients who underwent surgery for acute aortic dissection type A from May 2009 to May 2016 were divided into two groups based on their mechanical ventilation time after surgery, including 70 patients with mechanical ventilation 48 hours or more(group A), 132 patients with mechanical ventilation less than 48 hours (group B). Univariate and multivariate analysis(logistic regression) were used to identify the predictive risk factors. Results The mechanical ventilation time was(146. 8 ±78. 5)h and(21. 7 ±9. 5)h in group A and group B respectively. Overall inhospital mortality was 8. 6％ and 2. 3％. Multivariate logistic analysis showed that BMI(OR = 5. 956, 95％ CI: 2. 585 - 13. 723, P =0. 000), CPB time(OR =1. 108, 95％CI: 1. 052 -1. 166, P =0. 000), DHCA(OR =4. 562, 95％ CI: 1. 250 - 16. 640, P =0. 022), red blood cell transfusion intraoperative and in 24 hours postoperatively(OR =2. 625, 95％ CI: 1. 515 -4. 549, P =0. 001) were the independent predictors for prolonged mechanical ventilation. Conclusion The incidence of prolonged mechanical ventilation is high after surgery for stanford type A acute aortic dissection. It can be predicted based on above factors, for patients with these risk factors, more perioperative care strategies are needed in order to shorten the mechanical ventilation time.