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Outcome for cardiothoracic surgical patients requiring multidisciplinary intensive care

Published online by Cambridge University Press:  11 July 2005

R. J. Roche ,
A. D. Farmery  and
C. S. Garrard
R. J. Roche
Affiliation:
John Radcliffe Hospital, Intensive Care Unit, Headington, Oxford, UK
A. D. Farmery
Affiliation:
John Radcliffe Hospital, Intensive Care Unit, Headington, Oxford, UK
C. S. Garrard
Affiliation:
John Radcliffe Hospital, Intensive Care Unit, Headington, Oxford, UK
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Summary

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.

Keywords

CARDIAC SURGICAL PROCEDURESCRITICAL CARE, intensive careEPIDEMIOLOGIC FACTORS, causality, risk factors
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 9 , September 2003 , pp. 719 - 725
Copyright
© 2003 European Society of Anaesthesiology

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