Skip to main content Accessibility help

Outcome for cardiothoracic surgical patients requiring multidisciplinary intensive care

  • R. J. Roche (a1), A. D. Farmery (a1) and C. S. Garrard (a1)



Background and objective: Patients who require multidisciplinary intensive care after cardiac surgery have a poor prognosis. The aim was to investigate factors in the mortality of this group of patients at 6 months.

Methods: A retrospective analysis was made of the 6-month mortality rate in 301 adults who required admission to a multidisciplinary intensive care unit following cardiac surgery from 1991 to 1997. Mortality was correlated with clinical and patient characteristic variables.

Results: The intensive care mortality rate was 34% and at 6 months after patients' discharge from intensive care it was 51%. There were positive correlations with death at 6 months for ventricular failure (odds ratio of death 3.4, P = 0.002), sepsis (odds ratio 3.0, P = 0.004) and age over 80 yr (odds ratio of death 9.2, P = 0.034). Patients who had undergone isolated coronary artery graft surgery (odds ratio of death 0.28, P = 0.036) or thoracic surgery (odds ratio of death 0.22, P = 0.042) had better 6-month outcomes. Patients with respiratory or renal failure in the absence of ventricular failure or sepsis had a 6-month mortality rate of 36%; but the lower mortality rate did not achieve statistical significance.

Conclusions: The 6-month mortality rate of 51% in a group of patients requiring multidisciplinary intensive care after cardiac surgery is consistent with previous studies; mortality was particularly high in extreme old age and in patients referred with sepsis or ventricular failure. Those patients with uncomplicated respiratory or renal failure had a better outcome than the group as a whole.


Corresponding author

Correspondence to: R. John Roche, Department of Anaesthesia, Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK. E-mail:; Tel: +44 0 1865 331642


Hide All


Favaloro R. Saphenous vein autograft replacement of severe segmental coronary artery occlusions: operative technique. Ann Thorac Surg 1968; 5: 334339.
Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet 1994; 344: 563570.
Westaby S, Pillai R, Parry A, et al. Does modern cardiac surgery require conventional intensive care? Eur J Cardiothorac Surg 1993; 7: 313318.
Reyes A, Vega G, Blancas R, et al. Early vs conventional extubation after cardiac surgery with cardiopulmonary bypass. Chest 1997; 112: 193201.
Chong JL, Pillai R, Fisher A, Grebenik C, Sinclair M, Westaby S. Cardiac surgery: moving away from intensive care. Br Heart J 1992; 68: 430433.
Cheng DC, Karski J, Peniston C, et al. Morbidity outcome in early versus conventional tracheal extubation after coronary artery bypass grafting: a prospective randomized controlled trial. J Thorac Cardiovasc Surg 1996; 112: 755764.
Bashour CA, Yared JP, Ryan TA, et al. Long-term survival and functional capacity in cardiac surgery patients after prolonged intensive care. Crit Care Med 2000; 28: 38473853.
Thompson M, Elton R, Mankad P, et al. Prediction of requirement for, and outcome of, prolonged mechanical ventilation following cardiac surgery. Cardiovasc Surg 1997; 5: 376381.
Trouillet JL, Scheimberg A, Vuagnat A, Fagon JY, Chastre J, Gibert C. Long term outcome and quality of life of patients requiring multidisciplinary intensive care unit admission after cardiac operations. J Thorac Cardiovasc Surg 1996; 112: 926934.
Kollef MH, Wragge T, Pasque C. Determinants of mortality and multiorgan dysfunction in cardiac surgery patients requiring prolonged mechanical ventilation. Chest 1995; 107: 13951401.
Holmes L, Loughead K, Treasure T, Gallivan S. Which patients will not benefit from further intensive care after cardiac surgery? Lancet 1994; 344: 12001202.
Ryan TA, Rady MY, Bashour CA, Leventhal M, Lytle B, Starr NJ. Predictors of outcome in cardiac surgical patients with prolonged intensive care stay. Chest 1997; 112: 10351042.
Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. Chest 1992; 101: 16441655.
Altman DG. Practical Statistics for Medical Research. New York, USA: Chapman & Hall, 1991.
Gehlot AS, Santamaria JD, White AL, Ford GC, Ervine KL, Wilson AC. Current status of coronary artery grafting in patients 70 years of age and older. Aust N Z J Surg 1995; 65: 177181.
Deiwick M, Tandler R, Mollhoff T, et al. Heart surgery in patients aged eighty and above: determinants of mortality and morbidity. Thorac Cardiovasc Surg 1997; 45: 119126.
Geraci JM, Rosen AK, Ash AS, McNiff KJ, Moskowitz MA. Predicting the occurrence of adverse events after coronary artery bypass surgery. Ann Intern Med 1993; 118: 1824.
Hammermeister KE, Burchfiel C, Johnson R, Grover FL. Identification of patients at greatest risk for developing major complications at cardiac surgery. Circulation 1990; 82 (Suppl IV): 380389.
Chang RW, Jacobs S, Lee B, Pace N. Predicting deaths among intensive care unit patients. Crit Care Med 1988; 16: 3442.
Higgins T, Starr N, Lee J-C, Beck G, Estafanous F. Predicting prolonged intensive care unit length of stay following coronary artery bypass surgery. Clin Intensive Care 1999; 10: 175182.
Rady MY, Ryan T. Perioperative predictors of extubation failure and the effect on clinical outcome after cardiac surgery. Crit Care Med 1999; 27: 340347.
Söderlind K, Rutberg H, Olin C. Late outcome and quality of life after complicated heart operations. Ann Thorac Surg 1997; 63: 124128.
Nielsen D, Sellgren J, Ricksten SE. Quality of life after cardiac surgery complicated by multiple organ failure. Crit Care Med 1997; 25: 5257.


Outcome for cardiothoracic surgical patients requiring multidisciplinary intensive care

  • R. J. Roche (a1), A. D. Farmery (a1) and C. S. Garrard (a1)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed