title: [Mid-term outcome of cardiac surgery patients with prolonged postoperative intensive care treatment].
abstract: BACKGROUND
  The number of patients of advanced age and with severe comorbidities undergoing cardiac surgery is rising. Therefore, in addition to the cardiac surgery procedure itself, postoperative intensive care treatment plays an increasingly important role. The mid-term outcome of patients with postoperative long-term stays in intensive care and perioperative risk factors for an adverse outcome have not been sufficiently evaluated.
  
  
  METHODS
  All patients who underwent cardiac surgery in our institution between 2000 and 2004 and who required intensive care treatment on our cardiac surgery intensive care unit for at least 1 week were analyzed. Patients who received heart or lung transplantation or surgery for congenital heart failure were excluded. A total of 31 perioperative variables were evaluated for 230 patients. Follow-up was performed 1 year postoperatively.
  
  
  RESULTS
  In all, 4.3% of our patients required a prolonged stay in intensive care following cardiac surgery. Overall 1-year mortality among patients with a long-term stay in intensive care was 26.9%. The logistic regression identified postoperative renal failure requiring dialysis (OR 4.98) as the strongest predictor for mortality within the first year after surgery, followed by postoperative tracheotomy and preoperatively known atrial fibrillation.
  
  
  CONCLUSIONS
  Mid-term survival among patients who underwent cardiac surgery followed by a complicated postoperative course is encouragingly high. The risk factors identified for an adverse prognosis may be helpful in improving therapy strategies and general therapy decision-making.
authors: Klinik für Herz- und Gefäßchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland. jan.schoettler@uksh-kiel.de
authors: J
authors: J
authors: Schöttler
authors: A
authors: A
authors: Hagemann
authors: C
authors: C
authors: Grothusen
authors: S
authors: S
authors: Stohn
authors: D
authors: D
authors: Pleger
authors: M
authors: M
authors: von der Brelie
authors: J
authors: J
authors: Cremer
authors: N
authors: N
authors: Haake
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000401:mortality; D003422:Critical Care / Q000379:methods*; D005260:Female; D005858:Germany; D006331:Heart Diseases / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D006435:Renal Dialysis; D012307:Risk Factors; D015996:Survival Rate; D014140:Tracheotomy