title: Outcome for cardiothoracic surgical patients requiring multidisciplinary intensive care.
abstract: 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.
authors.affiliation: John Radcliffe Hospital, Intensive Care Unit, Headington, Oxford, UK. rocherj@onetel.net.uk
authors.forename: R J
authors.initials: RJ
authors.lastname: Roche
authors.forename: A D
authors.initials: AD
authors.lastname: Farmery
authors.forename: C S
authors.initials: CS
authors.lastname: Garrard
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D003422:Critical Care / Q000706:statistics & numerical data; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D016017:Odds Ratio; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome