Survival and quality of life after a long-term intensive care stay.
OBJECTIVE
The growing number of high-risk patients in cardiac surgery unavoidably leads to more complications, and therefore to a prolonged stay in an intensive care unit (ICU). The aim of our investigation was to elaborate on the fate of patents after long-term ICU treatment.


METHODS
Out of 5055 patients, 232 had to be treated for longer than 5 days in ICU. These 232 patients were analyzed for in-hospital mortality and followed up for quality of life. The Barthel mobility index and geriatric depression scale by Sheikh and Yesavage were used to evaluate physical ability and mood disturbances. Follow-up time was 82 months, and could be completed for 99 % of the patents.


RESULTS
In-hospital mortality was 34.6 %, with the majority of cases being coronary artery bypass grafting procedures (59.9 %). Average stay in ICU was 12.0 days for the survivors and 17 days for non-survivors. During follow-up time (6 - 82 months), another 56 patients (23 %) died. Survivors (n = 98) were predominantly in NYHA classes l-ll (83 %) with a Barthel index of more than 80, representing adequate mobilization during daily life in 78 % of the patients. Results according to the geriatric depression scale were normal in the vast majority of patients (91 %) with severe or life threatening depressions in only 6 patients (8 %).


CONCLUSIONS
Long-term treatment of critically ill patients is admittedly burdened with high in-hospital and follow-up mortality. However, the excellent physical and psychological recovery of survivors unequivocally supports the employment of all technical and personnel resources within modern intensive care medicine.
Isgro
F
F
Klinik für Herzchirurgie, Herzzentrum Ludwigshafen, Germany. isogrof@klilu.de
Skuras
J A
JA
Kiessling
A-H
AH
Lehmann
A
A
Saggau
W
W
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome