Long-term survival and quality of life of patients with prolonged postoperative intensive care unit stay: Unmasking an apparent success
Objective Our objective was to evaluate the long-term survival and quality of life of patients who faced a prolonged (>10 days) postoperative stay in the intensive care unit and were discharged from the hospital. Methods Among 3125 consecutive patients who underwent cardiac operations in a 5-year...
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Published in | Journal of thoracic and cardiovascular surgery Vol. 134; no. 2; pp. 465 - 469 |
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Main Authors | , , , , , , , |
Format | Journal Article Conference Proceeding |
Language | English |
Published |
Philadelphia, PA
Mosby, Inc
01.08.2007
AATS/WTSA Elsevier |
Subjects | |
Online Access | Get full text |
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Summary: | Objective Our objective was to evaluate the long-term survival and quality of life of patients who faced a prolonged (>10 days) postoperative stay in the intensive care unit and were discharged from the hospital. Methods Among 3125 consecutive patients who underwent cardiac operations in a 5-year period, we prospectively identified 57 who faced a prolonged postoperative intensive care unit stay and were discharged alive from the hospital. Patients were enrolled in a prospective follow-up protocol and evaluated every 6 to 12 months both clinically and instrumentally. Results Mean intensive care unit stay was 34 ± 9 days (range 11–141 days). Follow-up was complete and mean follow-up time was 71 months. Overall survival was 12 (21%) of 57, and the majority of follow-up deaths were cardiac related. Of the surviving patients, only a small minority (4/12) regained full autonomy and returned to their previous lifestyle. Risk factors for prolonged intensive care unit stay were age, New York Heart Association/Canadian Cardiovascular Society class, hypertension, diabetes, low ejection fraction, aortic surgery, preoperative renal failure, nonelective surgery, prolonged cardiopulmonary bypass time, and perioperative use of aortic counterpulsator. Conclusions Patients who face a prolonged postoperative intensive care unit stay and who were discharged from the hospital have a very poor long-term outcome and even worse quality of life. These data lead to a consideration of the wisdom of using heroic treatment in patients who face a prolonged postoperative intensive care unit stay in view of the dismal clinical results and enormous use of hospital and human resources. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0022-5223 1097-685X |
DOI: | 10.1016/j.jtcvs.2007.04.028 |