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

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.