ARISCAT score fails to predict prolonged mechanical ventilation in patients undergoing open aortic surgery

Introduction: Vascular surgery carries a high risk of perioperative complications, particularly respiratory ones. Precise patient risk identification is crucial for optimizing care. Methods: This was a retrospective single-center study including patients who underwent open aortic surgery between November 2010 and March 2016. We collected data on baseline, intraoperative and postoperative course, we calculated the ARISCAT score, and analyzed its association with postoperative outcomes. Results: The final cohort comprised 487 predominantly male patients (81.5%), with a median age of 67 years (Q1-Q3: 62–74) and median procedure duration of 145 minutes (Q1-Q3: 115-180). The overall median ARISCAT score was 42 (Q1-Q3: 34–58), stratifying the majority into the intermediate (52.4%) or high-risk (37.0%) categories. In a univariable analysis we found an association between higher ARISCAT score and increased risk of sepsis (median 58 vs 42, p=0.005), pulmonary edema (median 54 vs 42, p=0.043), but not pneumonia (median 42 vs 42, p=0.199), prolonged mechanical ventilation (median 46 vs 42,p=0.591), multiple organ failure (median 46 vs 42, p=0.277), in-hospital mortality (median 49 vs 42, p=0.170), or 30-day mortality (median 49 vs 42, p=0.237). ARISCAT risk categories showed no statistically significant difference in mean length of stay (hospital or ICU) (p≥0.05 for both). Conclusions: The ARISCAT scale's utility in this high-risk cohort was limited, successfully predicting only sepsis and pulmonary edema but failing to identify significant risk for pneumonia, prolonged mechanical ventilation,multiple organ failure, mortality and length of hospital and ICU stays.