LATE OUTCOME AND QUALITY-OF-LIFE AFTER COMPLICATED HEART OPERATIONS

Background. patients with severe postoperative complications consume a great deal of the economic resources for intensive care. Our knowledg e of the late outcome and quality of life of these patients is scarce. Methods. One thousand five hundred twenty-two patients undergoing car diac operations during 1991 and 1992 were studied, and the 100 patient s who needed the most expensive treatment were identified. The patient s were retrospectively risk scored (Higgins score), and the clinical o utcome was studied. The surviving patients were followed up for 2 year s after the operation. Their quality of life and remaining symptoms we re assessed. Results. No significant age difference between groups was observed. There were significantly more women, emergency cases, high- risk patients, and postoperative complications in the studied group. M ortality rate during the first postoperative year was significantly hi gher in the studied group. Later the difference in mortality rate betw een the groups decreased. At the 2-year follow-up all the 72 surviving patients in the study group had returned home with less physical and psychological symptoms related to their heart disease. Conclusions. Th e cost of treating severe complications in the intensive care unit is high. However, the results of the present study indicate that even a v ery complicated postoperative course is not incompatible with a succes sful outcome in the long run. (C) 1997 by The Society of Thoracic Surg eons