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Effect of Prolonged Intensive Care Stay on Survival Following Coronary Surgery

Department of Cardiothoracic Surgery
¹ Department of Research and Development, The Cardiothoracic Centre, Liverpool NHS Trust, Liverpool, United Kingdom

For reprint information contact: Walid C Dihmis, FRCS Tel: 44 151 293 2309 Fax: 44 151 220 8573 Email: Walid.Dihmis{at}ctc.nhs.uk, The Cardiothoracic Center, Liverpool NHS Trust, Thomas Drive, Liverpool L14 3PE, United Kingdom.

The aim of the study was to examine midterm survival in patients who required prolonged recovery in the intensive care unit. The 5,186 consecutive patients who underwent isolated coronary surgery between April 1997 and March 2002 were retrospectively analyzed. Patients were classified as having prolonged ( > 3 days) or normal ( 3 days) stay in the intensive care unit. Patient records were matched to the National Health Service Strategic Tracing Service which records all-cause mortality in the UK. Case-mix was controlled for by constructing a propensity score from core patient characteristics, which was included along with the comparison variable in a multivariable analysis of outcome. Prolonged intensive care unit stay was recorded in 475 (9.16%) patients. Mortality was 9.14% during the study period with a total follow-up of 19,618 patient-years (mean, 3.8 years). Adjusted 5-year survival was 78.0% for prolonged intensive care unit stay vs. 90.7% for normal stay, with an adjusted hazard ratio for midterm mortality of 2.6 ( p < 0.001). Midterm mortality was significantly higher in patients with a prolonged intensive care unit stay following coronary bypass.