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Interventional Medicine and Applied Science
Authors: Christina Grothusen, Tim Attmann, Christine Friedrich, Sandra Freitag-Wolf, Nils Haake, Jochen Cremer, and Jan Schöttler

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.

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