Long-term functional outcome and performance status after intensive care unit re-admission: a prospective survey
| Autor: | Brian Marsh, G. P. Herbison, N. Conlon, Brian O'Brien |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty MEDLINE Patient Readmission Severity of Illness Index law.invention law Intensive care Severity of illness Humans Medicine Intensive care medicine Aged Performance status business.industry Glasgow Outcome Scale Incidence (epidemiology) Length of Stay Middle Aged Prognosis Intensive care unit Intensive Care Units Anesthesiology and Pain Medicine Emergency medicine Female Epidemiologic Methods business Complication Ireland Specialization |
| Zdroj: | British Journal of Anaesthesia. 100:219-223 |
| ISSN: | 0007-0912 |
| Popis: | Background Intensive care unit (ICU) re-admission identifies a high-risk group in terms of hospital mortality, length of stay, and resource utilization. Only hospital and ICU mortality are well described in the literature on critically ill patients needing re-admission. Methods With ethical committee approval, from a prospectively collected database of all admissions to a combined medical and surgical ICU from January 1 to December 31, 2004, we identified all ICU re-admissions from within the hospital and analysed the factors associated with increased incidence of re-admission. At 2–3 yr after discharge, we evaluated the functional outcome of the surviving re-admitted patients as Glasgow Outcome Score (GOS) and Karnofsky index and identified determinants of both mortality and good functional outcome. Results Seventy-three (7.4%) of the 1061 patients who survived their first ICU stay were re-admitted during the study period. Of the 73 re-admitted patients, 14 died in ICU, 17 died later in the same hospital stay, and 10 died in the interim. Thus, 32 (43.8%) were alive 2–3 yr after discharge. The median [IQR] GOS of the survivors was 4 (see Mackle and colleagues in One year outcome of intensive care patients with decompensated alcoholic liver disease. Br J Anaesth 2006; 97: 496–8 and Jennett and Bond in Assessment of outcome after severe brain damage. A practical scale. Lancet 1975; 1: 480–4) and their median Karnofsky index was 70 [70–90] at follow-up. The only independent predictors of favourable functional outcome at follow-up were lower Apache 2 scores on both first ICU admission and on re-admission. Conclusions Although the ICU, hospital, and subsequent mortalities are high in patients after ICU re-admission, most survivors at 2–3 yr had by then made a good functional recovery and were independent. |
| Databáze: | OpenAIRE |
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