Long-term survival and functional capacity in cardiac surgery patients after prolonged intensive care

Abstract

Many survivors of prolonged intensive care die soon after hospital discharge and many longer term survivors have a poor functional state. Therefore, hospital discharge is an incomplete measure of outcome for these patients, and longer follow-up is more appropriate. The relatively small number of patients who require prolonged intensive care consumes a disproportionate amount of the total ICU and total hospital direct cost.

Quality of Life in Relation to Length of Intensive Care Unit Stay After Cardiac Surgery

“…The other 16 studies were retrospective (Table 3). 3,7,9,[25][26][27][28][29][30][31][32][33][34][35][36][37] The retrospective studies included 1,438 patients. Two studies were prospective and included 100 patients.…”

“…Of the 18 studies reviewed, 17 were conducted in Europe 3-5,7,25-28,31-37 and 1 in the United States. 9 Given the heterogeneity of the included studies, statistical analysis could not be performed accurately.…”

“…Therefore, if already not predefined by an author, any study on QOL after cardiac surgery with length of ICU stay >24 hours [8][9][10] was included. Only studies for which patients were followed up for at least 3 months post-ICU discharge were included.…”

“…3,26,27,29,32,33,36,37 The next most common definition was >7 days, reported in 7 studies. 4,9,25,30,31,34,36 Two studies considered ≥2 days in the ICU as prolonged. 5,28 Another study defined prolonged ICU stay as ≥3 days.…”

“…7 There has been considerable debate on the definition of prolonged ICU stay after cardiac surgery, ranging widely from >24 hours to >14 days. [8][9][10] The incidence of prolonged ICU stay after cardiac surgery varies from 4% to 11%, depending on its definition. Some estimate that up to 36% of patients who undergo cardiac surgery experience a prolonged ICU stay.…”