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The long-term effects of prolonged intensive care stay post-cardiac surgery
  • Ursula Mackie-Savage,
  • Judith Lathlean
Ursula Mackie-Savage
University College London Hospitals NHS Foundation Trust
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Judith Lathlean
University of Southampton
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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.

Peer review status:ACCEPTED

20 Jul 2020Submitted to Journal of Cardiac Surgery
21 Jul 2020Submission Checks Completed
21 Jul 2020Assigned to Editor
21 Jul 2020Reviewer(s) Assigned
22 Jul 2020Review(s) Completed, Editorial Evaluation Pending
22 Jul 2020Editorial Decision: Revise Major
26 Jul 20201st Revision Received
27 Jul 2020Assigned to Editor
27 Jul 2020Submission Checks Completed
27 Jul 2020Reviewer(s) Assigned
28 Jul 2020Review(s) Completed, Editorial Evaluation Pending
28 Jul 2020Editorial Decision: Revise Minor
30 Jul 20202nd Revision Received
04 Aug 2020Submission Checks Completed
04 Aug 2020Assigned to Editor
04 Aug 2020Reviewer(s) Assigned
06 Aug 2020Review(s) Completed, Editorial Evaluation Pending
06 Aug 2020Editorial Decision: Accept