Long-stay predictors in the intensive care unit after Bentall procedure: retrospective research

Aim: To analyze the frequency of early postoperative complications and predictors of long-stay patients in the intensive care unit (ICU) after the Bentall procedure. Materials and methods: This retrospective study is based on the obtained medical records of adult patients (aged 18-75), who underwent Bentall procedure for an ascending aortic aneurysm between 2012 and 2021. Depending on the length of ICU stay, all patients were divided into two groups: length of ICU stay up to 3 days (group 1) and length of ICU stay longer than 3 days (group 2). Univariate and multivariate analysis (logistic regression) was used to determine prognostic risk factors. Results: Patients of the second group were characterized by reliably older age (p = 0.005), more frequent presence of arterial hypertension (p = 0.044) among concomitant diseases (p = 0.044) and significantly lower baseline glomerular filtration rate (GFR) (p = 0.045). In case of the second group of patients in comparison with the first one, cell saver was used 3.6 times (p = 0.0005) more often and almost 6 times (p = 0.0037) more often, as well as the need for rethoracotomy due to bleeding, 4.3 times (p = 0.0002) more often acute renal failure and 3.3 times (p = 0.0004) more often acute respiratory failure. Multivariate logistic analysis revealed two independent predictors of long-stay ICU: duration of mechanical ventilation (OR 1.204 [CI 1.053-1.377], p = 0.007) and development of acute renal failure (OR 4,069 [CI 1,040-15,923], p = 0.044). Conclusions: All the patients must be treated in the same way to avoid per-and postoperative complications, but patients with risk factors for long-stay ICU should be under special attention.