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Quality of life after cardiac surgery complicated by multiple organ failure
D Nielsen1, J Sellgren, S E Ricksten
1Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital, Göteborg, Sweden.
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.