Jl. Trouillet et al., LONG-TERM OUTCOME AND QUALITY-OF-LIFE OF PATIENTS REQUIRING MULTIDISCIPLINARY INTENSIVE-CARE UNIT ADMISSION AFTER CARDIAC OPERATIONS, Journal of thoracic and cardiovascular surgery, 112(4), 1996, pp. 926-934
Patients with organ failure or severe infection after cardiac operatio
ns may require prolonged stags in the intensive care unit This study e
xamined long-term mortality and determined quality of life for survivi
ng patients in this group. This observational cohort study was conduct
ed at Bichat Hospital, Paris, an academic tertiary care center, The st
udy group consisted of 116 consecutive patients who underwent cardiac
operations and were transferred to tile multidisciplinary intensive ca
re 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 inten
sive care unit, Twenty-seven patients (23.3%) died in the intensive ca
re unit, Presurgical New York Heart Association functional class, post
operative bacteremia before admission to the intensive care unit, and
severity of illness on admission to the intensive care unit were indep
endent predictors of death in the intensive care unit, After an averag
e 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. Preop
erative New York Heart Association functional class was the only long-
term independent prognostic factor, Quality of life, as evaluated by t
he Nottingham Health Profile, tvas good for more than 70% of the survi
vors and tvas not influenced by any recorded variables, with the excep
tion of age.