Long-term outcomes in patients requiring stay of more than 48 hours in the intensive care unit following coronary bypass surgery.
BACKGROUND
The primary objective of this study was to determine the long-term outcomes of all patients requiring prolonged intensive care unit (ICU) stay following coronary bypass surgery (CABG) surgery.


METHODS
All patients undergoing CABG surgery between 1998 and 2002 were reviewed. Prolonged ICU stay was defined as more than 48 hours. Short-term (in-hospital) and long-term (postdischarge) outcomes were evaluated using available databases.


RESULTS
Of 3139 patients who underwent CABG surgery, 598 required an ICU stay of more than 48 hours (19%). The in-hospital mortality for patients requiring prolonged ICU stay was 10.0% as compared with 1.2% for the remainder of patients (P < .0001). The median length of hospitalization for patients requiring prolonged stay was 11 days (IQR 7-18) as compared to 6 days (IQR 5-7). The median follow-up of patients who survived to discharge was 31 months with a 100% follow-up. Using Cox proportional hazard ratio, patients who required a prolonged ICU stay were found to have a significant lower survival and freedom from cardiac readmission to the hospital. Prolonged ICU stay was an independent predictor of composite outcome (death + readmission) with a hazard ratio of 1.8 (1.5-2.1).


CONCLUSIONS
Prolonged ICU stay following CABG resulted in increased early and late mortality and lower freedom from readmission to hospital for cardiac reasons.
Heimrath
Olivier P
OP
Department of Surgery, Division of Cardiac Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Buth
Karen J
KJ
Légaré
Jean-Francois
JF
D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data; D011184:Postoperative Period; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome