. We retrospectively analyzed all adult cardiac surgical
patients in 1998 for ICU stays more than 14 days. Data were
range 0 to 24) and hospital charges.
patients remained in the ICU more than 14
days, comprising 3.8% of our patients but 28% of total ICU bed
time. This population had a 28.5% hospital mortality, which
was greater than those in the ICU less than 14 days (5.3%, p
< 0.05). By 2 years, 22 of the 35 discharged patients were
alive, 16 of whom had a normal quality of life. Patients alive
at 2 years had lower MODS at day 14 than those who died (2.6
± 1.4 versus 5.5 ± 3.8; p
< 0.005) as well
as lower hospital costs ($223,000 ± $128,000 versus $306,000
± $128,000; p
< 0.05). No patient with an MODS of
at least 6 at day 14 survived.
Conclusions. Patients remaining in the ICU for more than 14 days suffer a higher mortality at greater expense. A MODS at day 14 may help predict those who will not enjoy long-term survival and thus aid in the decision to terminate care.