Key result
Prolonged ICU care for postoperative organ failure is linked to ~10-point worse long-term quality of life.
Why the study?
The study aimed to evaluate quality of life in cardiac surgical patients after prolonged multiple system intensive care treatment for multiple organ failure.
Does prolonged intensive care for multiple organ failure after cardiac surgery reduce long-term quality of life compared to an uncomplicated postoperative course?
Case-Control (n=94)
No
Does prolonged intensive care for multiple organ failure after cardiac surgery reduce long-term quality of life compared to an uncomplicated postoperative course?
Patients surviving multiple organ failure after cardiac surgery have significantly reduced quality of life at least 1 year post-discharge compared to those with uncomplicated recoveries.
Answers are grounded in this paper and cite their sources.
May support counseling on expected QoL trajectories after post-cardiac surgery multiple organ failure; leaves open causality and need for prospective studies.
Objective To evaluate quality of life after prolonged multiple system intensive care treatment in cardiac surgical patients. Design A case-control study. Setting Adult 12-bed thoracic intensive care unit (ICU) at a university teaching hospital. Patients Forty-seven patients surviving multiple organ failure requiring intensive care treatment for > or = 5 days (ICU group). Patients with a completely uncomplicated postoperative course were matched to the study group with respect to gender, age, and type and date of surgery. The Nottingham Health Profile was used to assess quality of life at least 1 yr after complicated cardiac surgery. Interventions Quality of life measures were collected at least 1 yr after discharge from the ICU. Measurements and main results Seventy-five percent of the patients in the ICU group suffered from multiple organ failure involving at least three organ systems, with a mean stay in the ICU of 9.0 +/- 1.2 (SEM) days. Quality of life was considerably reduced in the ICU group, with a higher total mean score of all dimensions of quality of life (22.7 +/- 2.6) compared with the control group (13.2 +/- 2.4 [SEM])(p < .01). The Nottingham Health Profile score was higher in three of six dimensions of health--i.e., energy (p < .05), physical mobility (p < .05), and emotional reactions (p < .05)--compared with the control group. A higher percentage of patients reported problems in three of six important activities of daily life--housework (p < .05), hobbies (p < .01), and sex life (p < .01)--compared with the control group. Conclusion Patients treated with prolonged multiple system intensive care after heart surgery have a poor outcome with respect to quality of life measured at least 1 yr after discharge from the ICU.
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Nielsen et al. (1997) conducted a case-control in Multiple organ failure after cardiac surgery (n=94). Prolonged multiple system ICU treatment (≥5 days) for multiple organ failure vs. Uncomplicated postoperative course after cardiac surgery was evaluated on Total mean score of all dimensions of quality of life on the Nottingham Health Profile at least 1 year after surgery (p=<0.01). Prolonged ICU care for multiple organ failure after cardiac surgery was associated with worse quality of life at ≥1 year vs uncomplicated controls.
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