Effect of length of stay in intensive care unit on hospital and long-term mortality of critically ill adult patients
| Autor: | Kwok-ming Ho, Matthew Knuiman, Steve Webb, Teresa A. Williams, Judith Finn, Geoffrey J. Dobb |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Critical Illness law.invention Young Adult law medicine Humans Young adult Risk factor Intensive care medicine Aged Aged 80 and over Adult patients Critically ill business.industry Age Factors Western Australia Length of Stay Middle Aged Prognosis medicine.disease Comorbidity Intensive care unit Patient Discharge Intensive Care Units Anesthesiology and Pain Medicine Emergency medicine Critical illness Female Epidemiologic Methods business Cohort study |
| Zdroj: | British Journal of Anaesthesia. 104:459-464 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aeq025 |
| Popis: | Background Critical illness leading to prolonged length of stay (LOS) in an intensive care unit (ICU) is associated with significant mortality and resource utilization. This study assessed the independent effect of ICU LOS on in-hospital and long-term mortality after hospital discharge. Methods Clinical and mortality data of 22 298 patients, aged 16 yr and older, admitted to ICU between 1987 and 2002 were included in this linked-data cohort study. Cox's regression with restricted cubic spline function was used to model the effect of LOS on in-hospital and long-term mortality after adjusting for age, gender, acute physiology score (APS), maximum number of organ failures, era of admission, elective admission, Charlson's co-morbidity index, and diagnosis. The variability each predictor explained was calculated by the percentage of the χ2 statistic contribution to the total χ2 statistic. Results Most hospital deaths occurred within the first few days of ICU admission. Increasing LOS in ICU was not associated with an increased risk of in-hospital mortality after adjusting for other covariates, but was associated with an increased risk of long-term mortality after hospital discharge. The variability on the long-term mortality effect associated with ICU LOS (2.3%) appeared to reach a plateau after the first 10 days in ICU and was not as important as age (35.8%), co-morbidities (18.6%), diagnosis (10.9%), and APS (3.6%). Conclusions LOS in ICU was not an independent risk factor for in-hospital mortality, but it had a small effect on long-term mortality after hospital discharge after adjustment for other risk factors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|