Table 1. Patient characteristics by ICU LOS.
ICU LOS, intensive care unit length of stay; OR, odds ratio; CI, confidence interval; BMI, body mass index; COPD, chronic obstructive pulmonary disease; EVAR, endovascular aneurysm repair; EVAR AORTO-UNILIAC/AORTO-UNIFEM PROSTH, EVAR with aorto-uniiliac/aorto-unifemoral prosthesis; EVAR W/AORTO-AORTIC TUBE PROSTH, EVAR with aorto-aortic tube prosthesis; EVAR W/MDLR BFRC PROSTHE 1 LIMB, EVAR with modular bifurcated prosthesis with one docking limb; EVAR W/MDLR BFRC PROSTH 2 LIMBS, EVAR with modular bifurcated prosthesis with two docking limbs; EVAR W/UNIBDY BFRC PROSTH, EVAR with unibody bifurcated prosthesis; PLMT XTN PROSTH EVAR/DSJ 1st VSL, placement of extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, initial vessel; ASA, American Society of Anesthesiologists; SSI, surgical site infection; CVA, cerebrovascular accident; CPR, cardiopulmonary resuscitation; DVT, deep vein thrombosis
| Variable | Total (N = 2468) | Group 1 ICU LOS <1 day (N = 1535) | Group 2 ICU LOS ≥1 day (N = 933) | OR (95% CI)* | P-value* | |
| Preoperative factors: | ||||||
| Age (years) | ||||||
| <60 | 138 (5.6) | 76 (55.1) | 62 (44.9) | Reference | 0.166 | |
| 60-69 | 638 (25.9) | 388 (60.8) | 250 (39.2) | 0.79 (0.55, 1.15) | ||
| 70-79 | 1001 (40.5) | 642 (64.1) | 359 (35.9) | 0.69 (0.48, 0.98) | ||
| ≥80 | 691 (28) | 429 (62.1) | 262 (37.9) | 0.75 (0.52, 1.08) | ||
| Sex | ||||||
| Female | 461 (18.7) | 266 (57.7) | 195 (42.3) | 1.26 (1.03, 1.55) | 0.028 | |
| Male | 2007 (81.3) | 1269 (63.2) | 738 (36.8) | Reference | ||
| Race | ||||||
| Hispanic | 40 (2.0) | 11 (27.5) | 29 (72.5) | 3.93 (1.95, 7.92) | <0.001 | |
| Non-Hispanic Black | 133 (6.6) | 64 (48.1) | 69 (51.9) | 1.61 (1.13, 2.29) | ||
| Non-Hispanic Other | 31 (1.5) | 14 (45.2) | 17 (54.8) | 1.81 (0.89, 3.70) | ||
| Non-Hispanic White | 1821 (89.9) | 1090 (59.9) | 731 (40.1) | Reference | ||
| BMI (kg/m^2) | ||||||
| <25 (normal) | 655 (27.5) | 374 (57.1) | 281 (42.9) | Reference | 0.004 | |
| 25-<30 (overweight) | 930 (39.0) | 605 (65.0) | 325 (35.0) | 0.72 (0.58, 0.88) | ||
| >30 (obese) | 798 (33.5) | 505 (63.3) | 293 (36.7) | 0.77 (0.63, 0.95) | ||
| Ruptured indication for surgery | ||||||
| Ruptured | 188 (7.7) | 31 (16.5) | 157 (83.5) | 9.86 (6.65, 14.64) | <0.001 | |
| Non-ruptured | 2255 (92.3) | 1490 (66.1) | 765 (33.9) | Reference | ||
| Transferred | ||||||
| Yes | 311 (12.6) | 95 (30.6) | 216 (69.4) | 4.57 (3.54, 5.91) | <0.001 | |
| No | 2156 (87.4) | 1440 (66.8) | 716 (33.2) | Reference | ||
| Elective surgery | ||||||
| Yes | 1874 (76.0) | 1331 (71.0) | 543 (29.0) | Reference | <0.001 | |
| No | 593 (24.0) | 203 (34.2) | 390 (65.8) | 4.71 (3.87, 5.73) | ||
| Diabetes (with oral agents or insulin) | ||||||
| No | 2080 (84.3) | 1308 (62.9) | 772 (37.1) | Reference | 0.081 | |
| Non-insulin dependent | 304 (12.3) | 184 (60.5) | 120 (39.5) | 1.11 (0.86, 1.41) | ||
| Insulin dependent | 84 (3.4) | 43 (51.2) | 41 (48.8) | 1.62 (1.04, 2.50) | ||
| Current smoker within one year | ||||||
| Yes | 827 (33.5) | 495 (59.8) | 332 (40.2) | 1.16 (0.98, 1.38) | 0.089 | |
| No | 1641 (66.5) | 1040 (63.4) | 601 (36.6) | Reference | ||
| Dyspnea | ||||||
| Yes | 378 (15.3) | 222 (58.7) | 156 (41.3) | 1.19 (0.95, 1.48) | 0.131 | |
| No | 2090 (84.7) | 1313 (62.8) | 777 (37.2) | Reference | ||
| Dependent functional health status prior to surgery | ||||||
| Yes | 76 (3.1) | 31 (40.8) | 45 (59.2) | 2.48 (1.56, 3.94) | <0.001 | |
| No | 2384 (96.9) | 1503 (63.0) | 881 (37.0) | Reference | ||
| History of severe COPD | ||||||
| Yes | 471 (19.1) | 251 (53.3) | 220 (46.7) | 1.58 (1.29, 1.93) | <0.001 | |
| No | 1997 (80.9) | 1284 (64.3) | 713 (35.7) | Reference | ||
| Congestive heart failure in 30 days prior to surgery | ||||||
| Yes | 56 (2.3) | 18 (32.1) | 38 (67.9) | 3.58 (2.03, 6.31) | <0.001 | |
| No | 2412 (97.7) | 1517 (62.9) | 895 (37.1) | Reference | ||
| Hypertension requiring medication | ||||||
| Yes | 1959 (79.4) | 1196 (61.0) | 763 (39.0) | 1.27 (1.04, 1.56) | 0.022 | |
| No | 509 (20.6) | 339 (66.6) | 170 (33.4) | Reference | ||
| Currently on dialysis (pre-op) | ||||||
| Yes | 43 (1.7) | 22 (51.2) | 21 (48.8) | 1.58 (0.87, 2.90) | 0.136 | |
| No | 2425 (98.3) | 1513 (62.4) | 912 (37.6) | Reference | ||
| Steroid use for chronic condition | ||||||
| Yes | 94 (3.8) | 54 (57.4) | 40 (42.6) | 1.23 (0.81, 1.87) | 0.334 | |
| No | 2374 (96.2) | 1481 (62.4) | 893 (37.6) | Reference | ||
| Preoperative transfusion | ||||||
| Yes | 70 (2.8) | 12 (17.1) | 58 (82.9) | 8.41 (4.49, 15.75) | <0.001 | |
| No | 2398 (97.2) | 1523 (63.5) | 875 (36.5) | Reference | ||
| Systemic sepsis | ||||||
| Yes | 93 (3.8) | 20 (21.5) | 73 (78.5) | 6.43 (3.89, 10.62) | <0.001 | |
| No | 2375 (96.2) | 1515 (63.8) | 860 (36.2) | Reference | ||
| Wound classification | ||||||
| Clean | 2447 (99.1) | 1529 (62.5) | 918 (37.5) | 0.24 (0.09, 0.62) | 0.003 | |
| Not clean | 21 (0.9) | 6 (28.6) | 15 (71.4) | Reference | ||
| Intra-operative factors: | ||||||
| Prior abdominal aortic surgery | ||||||
| Yes | 659 (29.7) | 396 (60.1) | 263 (39.9) | 1.17 (0.97, 1.41) | 0.102 | |
| No | 1562 (70.3) | 996 (63.8) | 566 (36.2) | Reference | ||
| Surgeon’s specialty | ||||||
| Vascular | 2400 (97.2) | 1504 (62.7) | 896 (37.3) | Reference | 0.005 | |
| Non-vascular | 68 (2.8) | 31 (45.6) | 37 (54.4) | 2.00 (1.23, 3.25) | ||
| Principal operative procedure | ||||||
| EVAR AORTO-UNILIAC/AORTO-UNIFEM PROSTH | 105 (4.3) | 58 (55.2) | 47 (44.8) | 1.35 (0.90, 2.02) | <0.001 | |
| EVAR W/AORTO-AORTIC TUBE PROSTH | 134 (5.4) | 58 (43.3) | 76 (56.7) | 2.19 (1.52, 3.14) | ||
| EVAR W/MDLR BFRC PROSTH 1 LIMB | 1091 (44.2) | 682 (62.5) | 409 (37.5) | Reference | ||
| EVAR W/MDLR BFRC PROSTH 2 LIMBS | 793 (32.1) | 549 (69.2) | 244 (30.8) | 0.74 (0.61, 0.90) | ||
| EVAR W/UNIBDY BFRC PROSTH | 198 (8.0) | 106 (53.5) | 92 (46.5) | 1.45 (1.07, 1.96) | ||
| PLMT XTN PROSTH EVAR/DSJ 1ST VSL | 147 (6.0) | 82 (55.8) | 65 (44.2) | 1.32 (0.93, 1.87) | ||
| Principal anesthesia technique | ||||||
| General | 2204 (89.4) | 1362 (61.8) | 842 (38.2) | 1.18 (0.90, 1.55) | 0.225 | |
| Non- general | 262 (10.6) | 172 (65.6) | 90 (34.4) | Reference | ||
| ASA classification | ||||||
| 1-2, no disturbance-mild disturbance | 92 (3.7) | 75 (81.5) | 17 (18.5) | Reference | <0.001 | |
| 3, severe disturbance | 1443 (58.7) | 1008 (69.9) | 435 (30.1) | 1.90 (1.11, 3.26) | ||
| 4-5, life-threatening-moribund | 924 (37.6) | 448 (48.5) | 476 (51.5) | 4.69 (2.73, 8.06) | ||
| Rupture of aneurysm | ||||||
| Yes | 10 (0.4) | 1 (10.0) | 9 (90.0) | 14.91 (1.89, 117.67) | 0.010 | |
| No | 2458 (99.6) | 1534 (62.4) | 924 (37.6) | Reference | ||
| Aneurysm diameter (cm) | ||||||
| ≤5.0 | 576 (24.6) | 356 (61.8) | 220 (38.2) | Reference | <0.001 | |
| 5.0-5.5 | 667 (28.5) | 479 (71.8) | 188 (28.2) | 0.64 (0.50, 0.81) | ||
| 5.5-6.0 | 455 (19.4) | 309 (67.9) | 146 (32.1) | 0.77 (0.59, 0.99) | ||
| >6.0 | 643 (27.5) | 334 (51.9) | 309 (48.1) | 1.50 (1.19, 1.88) | ||
| Proximal aneurysm extent | ||||||
| Infrarenal | 2074 (89.6) | 1359 (65.5) | 715 (34.5) | Reference | <0.001 | |
| Others (Juxta-, para-, supra-renal, type IV thoracoabdominal aneurysm) | 241 (10.4) | 99 (41.1) | 142 (58.9) | 2.73 (2.08, 3.58) | ||
| Distal extent | ||||||
| Aortic | 903 (47.3) | 645 (71.4) | 258 (28.6) | Reference | <0.001 | |
| Common iliac | 690 (36.2) | 442 (64.1) | 248 (35.9) | 1.40 (1.13, 1.73) | ||
| External iliac | 129 (6.7) | 69 (53.5) | 60 (46.5) | 2.17 (1.49, 3.16) | ||
| Internal iliac | 186 (9.8) | 95 (51.1) | 91 (48.9) | 2.40 (1.74, 3.30) | ||
| Access vessels (conduit, repair) | ||||||
| Yes | 102 (4.1) | 44 (43.1) | 58 (56.9) | 2.25 (1.51, 3.35) | <0.001 | |
| No | 2366 (95.9) | 1491 (63.0) | 857 (37) | Reference | ||
| Access | ||||||
| Attempted percutaneous access converted to open cutdown | 22 (0.9) | 13 (59.1) | 9 (40.9) | 1.40 (0.59, 3.30) | <0.001 | |
| Bilateral groin cutdown | 1028 (42.0) | 593 (57.7) | 435 (42.3) | 1.48 (1.25, 1.76) | ||
| One groin cutdown | 231 (9.4) | 141 (61.0) | 90 (39.0) | 1.29 (0.96, 1.73) | ||
| Percutaneous bilateral | 1169 (47.7) | 782 (66.9) | 387 (33.1) | Reference | ||
| Main body device | ||||||
| Cook Zenith Fenestrated | 74 (3.1) | 33 (44.6) | 41 (55.4) | Reference | 0.001 | |
| Regular EVARs | 2350 (96.9) | 1486 (63.2) | 864 (36.8) | 0.47 (0.29, 0.75) | ||
| Iliac branched device | ||||||
| Yes | 357 (14.5) | 199 (55.7) | 158 (44.3) | 1.37 (1.09, 1.72) | 0.007 | |
| No | 2111 (85.5) | 1336 (63.3) | 775 (36.7) | Reference | ||
| Aortic (bare metal) stent | ||||||
| Yes | 168 (6.8) | 80 (47.6) | 88 (52.4) | 1.89 (1.38, 2.59) | <0.001 | |
| No | 2300 (93.2) | 1455 (63.3) | 845(36.7) | Reference | ||
| Renal stent | ||||||
| Yes | 188 (7.6) | 66 (35.1) | 122 (64.9) | 3.35 (2.45, 4.57) | <0.001 | |
| No | 2280 (92.4) | 1469 (64.4) | 811 (35.6) | Reference | ||
| Hypogastric embolization | ||||||
| Yes | 175 (7.1) | 100 (57.1) | 75 (42.9) | 1.25 (0.92, 1.71) | 0.153 | |
| No | 2293 (92.9) | 1435 (62.6) | 858 (37.4) | Reference | ||
| Hypogastric revascularization | ||||||
| Yes | 154 (6.2) | 55 (36.2) | 97 (63.8) | 3.12 (2.22, 4.39) | <0.001 | |
| No | 2316 (93.8) | 1480 (63.9) | 836 (36.1) | Reference | ||
| Lower extremity revascularization | ||||||
| Yes | 113 (4.6) | 52 (46.0) | 61 (54.0) | 2.00 (1.37, 2.92) | <0.001 | |
| No | 2355 (95.4) | 1483 (63.0) | 872 (37.0) | Reference | ||
| Ischemic colitis | ||||||
| Yes | 26 (1.1) | 1 (3.9) | 25 (96.1) | 42.11 (5.71, 310.39) | <0.001 | |
| No | 2442 (98.9) | 1534 (62.8) | 908 (37.2) | Reference | ||
| Lower extremity ischemia | ||||||
| Yes | 41 (1.7) | 18 (43.9) | 23 (56.1) | 2.13 (1.14, 3.97) | 0.017 | |
| No | 2427 (98.3) | 1517 (62.5) | 910 (37.5) | Reference | ||
| Total operation time (minutes) | ||||||
| <90 | 651 (26.4) | 471 (72.3) | 180 (27.7) | Reference | <0.001 | |
| 90-120 | 629 (25.5) | 431 (68.5) | 198 (31.5) | 1.20 (0.95, 1.53) | ||
| 120-180 | 713 (28.8) | 442 (62.0) | 271 (38.0) | 1.60 (1.28, 2.02) | ||
| ≥180 | 475 (19.3) | 191 (40.2) | 284 (59.8) | 3.89 (3.03, 5.00) | ||
| Postoperative factors: | ||||||
| Discharge destination | ||||||
| Expired | 63 (2.6) | 12 (19.1) | 51 (80.9) | 8.33 (4.42, 15.72) | <0.001 | |
| Home | 2173 (88.1) | 1439 (66.2) | 734 (33.8) | Reference | ||
| Other | 228 (9.3) | 83 (36.4) | 145 (63.6) | 3.43 (2.58, 4.55) | ||
| Open wound/wound infection | ||||||
| Yes | 31 (1.3) | 14 (45.2) | 17 (54.8) | 2.02 (0.99, 4.11) | 0.054 | |
| No | 2437 (98.7) | 1521 (62.4) | 916 (37.6) | Reference | ||
| Superficial surgical site occurrence | ||||||
| Superficial surgical incisional SSI | 26 (1.1) | 14 (53.8) | 12 (46.2) | 1.42 (0.65, 3.07) | 0.380 | |
| No Complication | 2442 (98.9) | 1521 (62.3) | 921 (37.7) | Reference | ||
| Deep incisional SSI | ||||||
| Deep incisional SSI | 8 (0.3) | 1 (12.5) | 7 (87.5) | 11.59 (1.42, 94.32) | 0.022 | |
| No complication | 2460 (99.7) | 1534 (62.4) | 926 (37.6) | Reference | ||
| Wound disruption | ||||||
| Wound disruption | 3 (0.1) | 1 (33.3) | 2 (66.7) | 3.30 (0.30, 36.38) | 0.331 | |
| No complication | 2465 (99.9) | 1534 (62.2) | 931 (37.8) | Reference | ||
| Pneumonia | ||||||
| Pneumonia | 44 (1.8) | 4 (9.1) | 40 (90.9) | 17.14 (6.11, 48.08) | <0.001 | |
| No complication | 2424 (98.2) | 1531 (63.2) | 893 (36.8) | Reference | ||
| Pulmonary embolism | ||||||
| Pulmonary embolism | 8 (0.3) | 1 (12.5) | 7 (87.5) | 11.59 (1.42, 94.32) | 0.022 | |
| No complication | 2460 (99.7) | 1534 (62.4) | 926 (37.6) | Reference | ||
| Urinary tract infection | ||||||
| Urinary tract infection | 24 (1.0) | 11 (45.8) | 13 (54.2) | 1.96 (0.87, 4.39) | 0.103- | |
| No complication | 2444 (99.0) | 1524 (62.4) | 920 (37.6) | Reference | ||
| Acute renal failure | ||||||
| Acute renal failure | 24 (1.0) | 1 (4.2) | 23 (95.8) | 38.69 (5.23, 286.45) | <0.001 | |
| No complication | 2444 (99.0) | 1534 (62.8) | 910 (37.2) | Reference | ||
| CVA/stroke with neurological deficit | ||||||
| CVA/stroke | 11 (0.5) | 2 (18.2) | 9 (81.8) | 7.47 (1.61, 34.63) | 0.010 | |
| No complication | 2457 (99.5) | 1533 (62.4) | 924 (37.6) | Reference | ||
| Cardiac arrest requiring CPR | ||||||
| Cardiac arrest requiring CPR | 39 (1.6) | 11 (28.2) | 28 (71.8) | 4.29 (2.12, 8.65) | <0.001 | |
| No complication | 2429(98.4) | 1524 (62.7) | 905 (37.3) | Reference | ||
| Myocardial infarction | ||||||
| Myocardial infarction | 40 (1.6) | 6 (15.0) | 34 (85.0) | 9.64 (4.03, 23.04) | <0.001 | |
| No complication | 2428 (98.4) | 1529 (63.0) | 899 (37.0) | Reference | ||
| Bleeding transfusion | ||||||
| Transfusion intraoperative/postoperative | 309 (12.5) | 59 (19.1) | 250 (80.9) | 9.16 (6.80, 12.33) | <0.001 | |
| No complication | 2159 (87.5) | 1476 (68.4) | 683 (31.6) | Reference | ||
| DVT/thrombophlebitis | ||||||
| DVT requiring therapy | 14 (0.6) | 2 (14.3) | 12 (85.7) | 9.99 (2.23, 44.71) | 0.003 | |
| No complication | 2454 (99.4) | 1533 (62.5) | 921 (37.5) | Reference | ||
| Sepsis | ||||||
| Sepsis | 14 (0.6) | 4 (28.6) | 10 (71.4) | 4.15 (1.30, 13.26) | 0.017 | |
| No complication | 2454 (99.4) | 1531 (62.4) | 923 (37.6) | Reference | ||
| Return to operation room | ||||||
| Yes | 128 (5.2) | 46 (35.9) | 82 (64.1) | 3.12 (2.15, 4.52) | <0.001 | |
| No | 2340 (94.8) | 1489 (63.6) | 851 (36.4) | Reference | ||
| Unplanned readmission | ||||||
| Yes | 188 (7.6) | 82 (43.6) | 106 (56.4) | 2.27 (1.68, 3.07) | <0.001 | |
| No | 2280 (92.4) | 1453 (63.7) | 827 (36.3) | Reference | ||
| * All odds ratios and p-values are from binomial logistic regression modeling ICU LOS ≥1, exact logistic regression used as needed. When an association is significant (p-value), odds ratios with 95% confidence limits not including 1 are considered significant. | ||||||