title: Predictors for long-term outcome and quality of life of patients after cardiac surgery with prolonged intensive care unit stay.
abstract: OBJECTIVE
  This study investigated factors determining the long-term outcome and quality of life of patients with a prolonged intensive care unit (ICU) stay after cardiac surgery.
  
  
  METHODS
  A retrospective analysis was performed in 230 patients that had undergone cardiac surgery and suffered from a post-operative ICU stay of 7 or more days at our institution. Among 11 pre-, 13 intra-, and 14 post-operative variables, factors influencing 5-year outcome were identified by logistic regression analysis. Quality of life was determined using the Short Form-36 questionnaire.
  
  
  RESULTS
  In-hospital mortality was 12%. One hundred and eleven of 187 patients (59%) were alive after 5 years. Non-survivors were older (70 vs. 65 years, p = 0.005) and had a higher additive EuroSCORE (7 vs. 5, p = 0.034). Logistic regression identified pre-operative atrial fibrillation (AF), (28 vs. 10%, p = 0.003) as the strongest predictor for a 5-year outcome, followed by myocardial infarction (62 vs. 41%, p = 0.005), and prolonged mechanical ventilation (8 vs. 5 days, p = 0.036). Survivors did not show an impaired physical component summary SF-36 score (39 vs. 46, p = 0.737) or mental component summary score (55 vs. 55, p = 0.947) compared to an age-matched German Normative Sample.
  
  
  CONCLUSIONS
  Pre-operative AF proved to be the most important factor determining the 5-year outcome of patients with a prolonged ICU stay after cardiac surgery. Neither physical nor mental health appeared to be impaired in these patients.
authors.forename: Christina
authors.initials: C
authors.lastname: Grothusen
authors.forename: Tim
authors.initials: T
authors.lastname: Attmann
authors.forename: Christine
authors.initials: C
authors.lastname: Friedrich
authors.forename: Sandra
authors.initials: S
authors.lastname: Freitag-Wolf
authors.forename: Nils
authors.initials: N
authors.lastname: Haake
authors.forename: Jochen
authors.initials: J
authors.lastname: Cremer
authors.forename: Jan
authors.initials: J
authors.lastname: Schöttler
keywords: atrial fibrillation; cardiac surgery; outcome; prolonged intensive care unit stay; quality of life