Background The proportion of people >60 years of age is projected to double from 11% to 22% by 2050 High risk patients, with significant co-morbidities, who are undergoing major cardiac surgery has increased up to 18% in the last 5 years. Up to 11% of patients undergoing cardiac surgery endure prolonged intensive care unit (ICU) stay. The impact of prolonged ICU stay on clinical outcomes, functional status and quality of life (QOL) is unclear. Recently, there is more emphasis about QOL rather than prolonging life. Hypothesis High risk patients; with significant co-morbidities and advanced age, undergoing cardiac surgery have an increased risk of prolonged ICU stay. Is it possible to preoperatively identify which of these patients will endure a prolonged ICU stay and will that cohort regain or improve their quality of life and functional status?