Abstract
Objectives: Short-term outcomes for those with a prolonged length of
stay (LOS) in intensive care (ITU) following cardiac surgery are poor,
with higher rates of in-hospital mortality and morbidity. Consequently,
discharge from hospital has been considered the key measure of success.
However, there has been a shift towards long-term outcomes, functional
recovery and quality of life (QoL) as measures of surgical quality. The
aim of this review is to compare and critique the findings of multiple
studies in order to determine the long-term effects of prolonged ITU
stay post-cardiac surgery. Methods: A computerised literature search of
CINAHL, EMBASE and Google Scholar databases, based on keywords
‘long-term effects’; ‘prolonged ITU stay’; ‘cardiac surgery’, with
rigorous CASP critique, was undertaken. Results: The search yielded 12
papers meeting the inclusion criteria, with eight retrospective and four
prospective studies. Eight of these 12 papers identified inferior
long-term survival or higher mortality rates for those who had prolonged
LOS in ITU in comparison to ‘normal’ LOS or a control. The greatest
burden of mortality was six months to one year post-discharge. Three
papers found that quality of life was adversely affected or worse for
those who had experienced prolonged LOS in ITU. Conclusions: Further
research is required to provide better quality evidence into QoL,
following prolonged stay in ICU post cardiac surgery. The evidence
reviewed suggests that the risk of mortality in this demographic of
patients is higher, especially within the first year and, therefore,
more frequent medical surveillance of these patients is recommended.