Deschka Heinz, Schreier Romy, El-Ayoubi L'emir, Erler Stefan, Alken Aiman, Wimmer-Greinecker Gerhard
Department for Cardiothoracic Surgery, Heart and Vessel Center Bad Bevensen, Bad Bevensen, Germany.
Thorac Cardiovasc Surg. 2013 Dec;61(8):696-700. doi: 10.1055/s-0033-1342942. Epub 2013 Apr 25.
The rising prevalence of multimorbid patients undergoing cardiac surgery often leads to prolonged postoperative intensive care unit (ICU) treatment. The fate of these patients after discharge is poorly investigated. This study is aimed to assess survival, functional outcome, and quality of life (QOL) in patients after an ICU stay of at least 5 days.
Between August 2009 and July 2010, 1,092 patients underwent various cardiac procedures. Of these patients, 119 required ICU treatment of at least 5 days. Preoperative characteristics as well as postoperative course were analyzed and the discharged patients were contacted after 1 year to gain information about survival, functional capacity, and QOL.
European system for cardiac operative risk evaluation I of the patients was 22.3 ± 16.7. Mean ICU stay was 19 ± 20 days. Forty three patients (36.1%) died in the hospital, 1-year overall survival was 46.2%, and 1-year survival of the discharged patients was 72.4%. Barthel mobility index was 85, showing a satisfactory mobilization. QOL, assessed with short form 12 questionnaire, was comparable with the reference group.
Long-term ICU treatment after cardiac surgery is related to a high in-hospital and follow-up mortality. The physical and psychological recovery of the survivors is encouraging, justifying the extensive engagement of hospital resources.
接受心脏手术的多病患者日益增多,这常常导致术后重症监护病房(ICU)治疗时间延长。这些患者出院后的情况鲜有研究。本研究旨在评估在ICU住院至少5天的患者的生存率、功能转归和生活质量(QOL)。
2009年8月至2010年7月期间,1092例患者接受了各种心脏手术。其中,119例患者需要在ICU接受至少5天的治疗。分析患者的术前特征以及术后病程,并在1年后联系出院患者,以获取有关生存、功能能力和QOL的信息。
患者的欧洲心脏手术风险评估系统I评分为22.3±16.7。平均ICU住院时间为19±20天。43例患者(36.1%)在医院死亡,1年总生存率为46.2%,出院患者的1年生存率为72.4%。Barthel活动指数为85,显示出令人满意的活动能力。用简短健康调查问卷12评估的QOL与参照组相当。
心脏手术后长期ICU治疗与高院内死亡率和随访死亡率相关。幸存者的身心恢复情况令人鼓舞,证明了医院资源的大量投入是合理的。