title: Effect of prolonged intensive care stay on survival following coronary surgery.
abstract: The aim of the study was to examine midterm survival in patients who required prolonged recovery in the intensive care unit. The 5,186 consecutive patients who underwent isolated coronary surgery between April 1997 and March 2002 were retrospectively analyzed. Patients were classified as having prolonged (>3 days) or normal (<or=3 days) stay in the intensive care unit. Patient records were matched to the National Health Service Strategic Tracing Service which records all-cause mortality in the UK. Case-mix was controlled for by constructing a propensity score from core patient characteristics, which was included along with the comparison variable in a multivariable analysis of outcome. Prolonged intensive care unit stay was recorded in 475 (9.16%) patients. Mortality was 9.14% during the study period with a total follow-up of 19,618 patient-years (mean, 3.8 years). Adjusted 5-year survival was 78.0% for prolonged intensive care unit stay vs. 90.7% for normal stay, with an adjusted hazard ratio for midterm mortality of 2.6 (p<0.001). Midterm mortality was significantly higher in patients with a prolonged intensive care unit stay following coronary bypass.
authors.affiliation: Department of Cardiothoracic Surgery, The Cardiothoracic Center, Liverpool NHS Trust, Thomas Drive, Liverpool L14 3PE, United Kingdom.
authors.forename: Sanjay V
authors.initials: SV
authors.lastname: Ghotkar
authors.forename: Antony D
authors.initials: AD
authors.lastname: Grayson
authors.forename: Walid C
authors.initials: WC
authors.lastname: Dihmis
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology