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J Thorac Cardiovasc Surg 1996;112:926-934
© 1996 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

LONG-TERM OUTCOME AND QUALITY OF LIFE OF PATIENTS REQUIRING MULTIDISCIPLINARY INTENSIVE CARE UNIT ADMISSION AFTER CARDIAC OPERATIONS

From the Service de Reanimation Mééicale, Hôpital Bichat, Paris, France.

Received for publication Dec. 22, 1995 Revisions requested Feb. 21, 1996; revesions received May 13, 1996 Accepted for publication may 14, 1996. Address for reprints: Jean-Louis Trouillet, MD, Service de Réanimation Médicale, Hôpital Bichat, 46, rue Henti Huchard, 75877 Paris Cedex 18, France.

Abstract

Patients with organ failure or severe infection after cardiac operations may require prolonged stays in the intensive care unit. This study examined long-term mortality and determined quality of life for surviving patients in this group. This observational cohort study was conducted at Bichat Hospital, Paris, an academic tertiary care center. The study group consisted of 116 consecutive patients who underwent cardiac operations and were transferred to the multidisciplinary intensive care unit between January 1986 and December 1987. Patients referred for mediastinitis were automatically excluded. Respiratory failure (88.8%) and hemodynamic instability (81.9%) were the main causes of transfer; an infection was present in 23.3% of patients at entry into the intensive care unit. Twenty-seven patients (23.3%) died in the intensive care unit. Presurgical New York Heart Association functional class, postoperative bacteremia before admission to the intensive care unit, and severity of illness on admission to the intensive care unit were independent predictors of death in the intensive care unit. After an average follow-up of 81 months (range 70 to 93 months), 69% of the patients alive at transfer from the intensive care unit were still alive. Preoperative New York Heart Association functional class was the only long-term independent prognostic factor. Quality of life, as evaluated by the Nottingham Health Profile, was good for more than 70% of the survivors and was not influenced by any recorded variables, with the exception of age. (J THORACCARDIOVASCSURG1996;112:926-34)

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