title: Outcomes of Patients With Prolonged Intensive Care Unit Length of Stay After Cardiac Surgery.
abstract: OBJECTIVE
  To determine in-hospital and post-discharge long-term survival in patients with prolonged intensive care unit (ICU) stays after cardiac surgery.
  
  
  METHODS
  Retrospective, cohort study of cardiac surgery patients from May 2007 to June 2012.
  
  
  METHODS
  Single-center cardiac surgery ICU.
  
  
  METHODS
  Patients were grouped according to length of ICU stay: between 1 and 2 weeks, between 2 and 4 weeks, and>4 weeks.
  
  
  METHODS
  None.
  
  
  RESULTS
  Of 4,963 patients, 3.3%, 1.6%, and 2.9% of patients stayed 1 to 2 weeks, 2 to 4 weeks, and>4 weeks in the ICU, respectively. In-hospital mortality was 11.1%, 26.6%, and 31.0% for patients with 1 to 2 weeks, 2 to 4 weeks, and>4 weeks ICU stay, respectively. Patients with ICU stays between 1 and 2 weeks had 6 months, 1 year, and 2 year survival rates of 84.4%, 80.0%, and 75.3% after discharge, respectively. Patients with ICU stay between 2 and 4 weeks had similar 6 months, 1 year, and 2 year survival rates of 84.7%, 79.9%, and 74.1%, respectively. In contrast, patients with>4 week ICU stays had significantly lower postdischarge survival rates of 63.3%, 56.4%, and 41.1% at 6 months, 1 year, and 2 years, respectively. Postoperative stroke conferred the greatest risk of death within 1 year after discharge (odds ratio 7.6, p = 0.0140).
  
  
  CONCLUSIONS
  In-hospital mortality rates post-cardiac surgery correlate with length of ICU stay but appear to plateau after 4 weeks. However, a>4 week ICU length of stay confers a worse long-term outcome post-hospital discharge, especially in patients with postoperative stroke.
authors: Hofstra Northwell School of Medicine, Department of Cardiovascular and Thoracic Surgery, Bay Shore, NY. Electronic address: pyu2@nshs.edu.
authors: Pey-Jen
authors: PJ
authors: Yu
authors: Hofstra Northwell School of Medicine, Department of Cardiovascular and Thoracic Surgery, Bay Shore, NY.
authors: Hugh A
authors: HA
authors: Cassiere
authors: The Feinstein Institute for Medical Research, Manhasset, NY.
authors: Joanna
authors: J
authors: Fishbein
authors: Hofstra Northwell School of Medicine, Department of Cardiovascular and Thoracic Surgery, Bay Shore, NY.
authors: Rick A
authors: RA
authors: Esposito
authors: Hofstra Northwell School of Medicine, Department of Cardiovascular and Thoracic Surgery, Bay Shore, NY.
authors: Alan R
authors: AR
authors: Hartman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures; D015331:Cohort Studies; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D015996:Survival Rate
keywords: cardiac surgical procedures; complication; hospital mortality; intensive care units; length of stay; outcome; stroke; survival rate