Open AccessPredictors for long-term outcome and quality of life of patients after cardiac surgery with prolonged intensive care unit stay
Author(s) -
Christina Grothusen,
Tim Attmann,
Christine Friedrich,
Sandra FreitagWolf,
Nils Haake,
Jochen Cremer,
J. Schöttler
Publication year - 2013
Publication title -
interventional medicine and applied science/interventional medicine and applied science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.195
H-Index - 14
eISSN - 2061-5094
pISSN - 2061-1617
DOI - 10.1556/imas.5.2013.1.1
Subject(s) - medicine , intensive care unit , atrial fibrillation , logistic regression , mechanical ventilation , cardiac surgery , quality of life (healthcare) , euroscore , surgery , emergency medicine , nursing
Objectives This study investigated factors determining the long-term outcome and quality of life of patients with a prolonged intensive care unit (ICU) stay after cardiac surgery. Design A retrospective analysis was performed in 230 patients that had undergone cardiac surgery and suffered from a post-operative ICU stay of 7 or more days at our institution. Among 11 pre-, 13 intra-, and 14 post-operative variables, factors influencing 5-year outcome were identified by logistic regression analysis. Quality of life was determined using the Short Form-36 questionnaire. Results In-hospital mortality was 12%. One hundred and eleven of 187 patients (59%) were alive after 5 years. Non-survivors were older (70 vs. 65 years, p =0.005) and had a higher additive EuroSCORE (7 vs. 5, p =0.034). Logistic regression identified pre-operative atrial fibrillation (AF), (28 vs. 10%, p =0.003) as the strongest predictor for a 5-year outcome, followed by myocardial infarction (62 vs. 41%, p =0.005), and prolonged mechanical ventilation (8 vs. 5 days, p =0.036). Survivors did not show an impaired physical component summary SF-36 score (39 vs. 46, p =0.737) or mental component summary score (55 vs. 55, p =0.947) compared to an age-matched German Normative Sample. Conclusions Pre-operative AF proved to be the most important factor determining the 5-year outcome of patients with a prolonged ICU stay after cardiac surgery. Neither physical nor mental health appeared to be impaired in these patients.