Predictors for long-term outcome and quality of life of patients after cardiac surgery with prolonged intensive care unit stay

Abstract

Abstract 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.