Introduction: Although admission to cardiac intensive care (CICU) is standard after cardiac surgery, significant numbers of patients are admitted to general intensive care units (ICU). The purpose of the present study was to examine mortality and factors that influence mortality in this patient group.
Method: Admissions to ICUs directly from theatre after surgery of the heart or thoracic aorta were identified in the database of the national audit of intensive and high-dependency care in Great Britain (the Case Mix Programme). Significance for mortality of factors that reflected unit characteristics, circumstances at admission, patient status at admission and during the initial 24 hours were analysed with multiple logistic regression.
Results: Between 1996-2001 there were 2697 admissions to 58 ICUs, 2420 of these admissions were to 11 ICUs in hospitals having a CICU. The number of admissions per unit and main surgical group is shown in table below.
The number of admissions and mortality per surgical group were CABG 1749, 4.8%; isolated valve 432, 9.0%; valve plus CABG 172, 9.5%, thoracic aorta 228, 29.0% and other 116, 17.7%. Corresponding mortality figures in the National Adult Cardiac Surgical Database Report 2000-2001  were for CABG 2.3%, isolated valve 4.8% and valve plus CABG 7.8%. Significant determinants of mortality were urgency of admission, age, serum creatinine, blood glucose, heart rate and arterial acid-base status.
Discussion: The substantial numbers of cardiac surgery patients admitted to ICUs indicated lack of beds in CICUs.
1 NACSD Report 2000-2001, page 50 (downloaded fromwww.ctsnet.org/file/SCTS2000 pages 46-59.pdf accessed Feb 26, 2004).