Are there accurate predictors of long-term vital and functional outcomes in cardiac surgical patients requiring prolonged intensive care?

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Philippe GersbachLudwig Karl von Segesser

Abstract

The decision to maintain intensive treatment in cardiac surgical patients with poor initial outcome is mostly based on individual experience. The risk scoring systems used in cardiac surgery have no prognostic value for individuals. This study aims to assess (a) factors possibly related to poor survival and functional outcomes in cardiac surgery patients requiring prolonged (> or = 5 days) intensive care unit (ICU) treatment, (b) conditions in which treatment withdrawal might be justified, and (c) the patient's perception of the benefits and drawbacks of long intensive treatments. The computerized data prospectively recorded for every patient in the intensive care unit over a 3-year period were reviewed and analyzed (n=1859). Survival and quality of life (QOL) outcomes were determined in all patients having required > or =5 consecutive days of intensive treatment (n=194/10.4%). Long-term survivors were interviewed at yearly intervals in a standardized manner and quality of life was assessed using the dependency score of Karnofsky. No interventions or treatments were given, withhold, or withdrawn as part of this study. In-hospital, 1-, and 3-year cumulative survival rates reached 91.3%, 85.6%, and 75.1%, respectively. Quality of...Continue Reading

Citations

Oct 7, 2011·Medizinische Klinik, Intensivmedizin und Notfallmedizin·J SchöttlerN Haake
Jun 16, 2012·Langenbeck's Archives of Surgery·Nina WeilerVolker Fendrich
Feb 27, 2010·British Journal of Anaesthesia·T A WilliamsUNKNOWN Royal Perth Hospital ICU Data Linkage Group
Mar 14, 2013·Interactive Cardiovascular and Thoracic Surgery·Gopal SoppaMarjan Jahangiri
Sep 1, 2009·American Journal of Surgery·Dharam J KumbhaniShukri F Khuri
Jul 4, 2015·Medical Science Monitor Basic Research·Fabian DoerrKhosro Hekmat
Jan 28, 2010·The Annals of Thoracic Surgery·Emma LagercrantzUlrik Sartipy
Mar 8, 2011·Journal of Critical Care·Kay H StrickerSonia Frick
Apr 27, 2013·Journal of the American College of Surgeons·Damien J LaParGorav Ailawadi
Aug 28, 2012·Critical Care Nursing Clinics of North America·Suzanne M Burns
Oct 4, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Mohammad DiabMarjan Jahangiri
Dec 31, 2008·Critical Care Medicine·Stephan M JakobJukka Takala
Jan 24, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Alexander KoganLeonid Sternik

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