title: Three-year survival after four major post-cardiac operative complications.
abstract: OBJECTIVE
  After cardiac surgery, major morbidities known to be primary contributors to perioperative mortality are cardiac failure, respiratory failure, renal failure, and the need for mediastinal exploration. The first aim of this study was to ascertain long-term survival in cardiac surgery patients with and without the occurrence of major morbidities to investigate if long-term survival was comparable. The second aim of this study was to evaluate the prevalences and risk factors related to the four major morbidities in this patient population.
  
  
  METHODS
  Retrospective observational outcome study.
  
  
  METHODS
  Cardiothoracic intensive care unit at a university hospital.
  
  
  METHODS
  We included 2,683 of 3,253 consecutive cardiac surgery patients cared for in a uniform fashion.
  
  
  RESULTS
  Perioperative mortality was significantly increased by the occurrence of major morbidity. In-hospital mortality was 0.7% in the absence of major morbidity compared with 72% when all major morbidities occurred. Three-year mortality for the entire study population was 15%, whereas the 3-yr long-term survival was significantly less for patients with morbidities compared with those without. Various independent perioperative risk factors were found for perioperative major morbidity and mortality.
  
  
  CONCLUSIONS
  Successful acute treatment and measures to identify and reduce the risk of major morbidities are necessary to improve outcome. In addition, long-term follow-up and management of morbidities are necessary to possibly improve long-term survival.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Campus Charite Mitte, Charite-University Medicine Berlin, Berlin, Germany. ortrud.vargas@charite.de
authors.forename: Ortrud Vargas
authors.initials: OV
authors.lastname: Hein
authors.forename: Jürgen
authors.initials: J
authors.lastname: Birnbaum
authors.forename: Klaus D
authors.initials: KD
authors.lastname: Wernecke
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Konertz
authors.forename: Uday
authors.initials: U
authors.lastname: Jain
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000401:mortality; D000368:Aged; D006348:Cardiac Surgical Procedures; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000453:epidemiology / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008482:Mediastinum / Q000601:surgery; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality*; D015995:Prevalence; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate