Factors associated with prolonged mechanical ventilation in adult patients postoperative cardiac surgery

Background Prolonged mechanical ventilation (PMV) after cardiac surgery is a major complication that worsens patient outcomes, making it crucial to identify predictive factors for better perioperative management. Objectives This study aimed to assess factors associated with PMV in adult patients postoperatively after cardiac surgery. Patients and methods A retrospective study was conducted on 182 adult patients who underwent cardiac surgery at Aswan Heart Centre, Egypt, between January and December 2024. Data was extracted from medical records using a structured tool. Data were analyzed with SPSS, version 21, using descriptive statistics and univariate and multivariate logistic regression to identify independent predictors of PMV (≥24 h), with significance set at P value less than 0.05. Results Out of 182 patients, 79 (43.4%) required PMV. Multivariate analysis identified redo surgery [odds ratio (OR) 3.34, P ≤0.007], preoperative heart failure (OR 2.87, P ≤0.009), intraoperative blood transfusion (OR 3.69, P <0.008), surgical duration more than or equal to 8 h (OR 7.85, P ≤0.001), cardiopulmonary bypass time 60–119 min (OR 16.19, P ≤0.001), coronary artery bypass graft surgery (OR 4.91, P =0.008), re-exploration for bleeding (OR 30.78, P ≤0.001), and postoperative renal dysfunction (OR 11.43, P ≤0.001) as independent predictors. Discussion PMV is common after cardiac surgery and is strongly linked to preoperative comorbidities, intraoperative complexity, and postoperative complications. This study provides novel evidence. underscoring the importance of early risk stratification and targeted perioperative strategies to improve outcomes. Further prospective studies are warranted to validate these predictors and develop preventive strategies.