Journal article
Conditional survival with increasing duration of ICU admission: an observational study of three intensive care databases
- Abstract:
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Objectives: Prolonged admissions to an ICU are associated with high resource utilization and personal cost to the patient. Previous reports suggest increasing length of stay may be associated with poor outcomes. Conditional survival represents the probability of future survival after a defined period of treatment on an ICU providing a description of how prognosis evolves over time. Our objective was to describe conditional survival as length of ICU stay increased.
Design: Retrospective observational cohort study of three large intensive care databases.
Setting: Three intensive care databases, two in the United States (Medical Information Mart for Intensive Care III and electronic ICU) and one in United Kingdom (Post Intensive Care Risk-Adjusted Alerting and Monitoring).
Patients: Index admissions to intensive care for patients 18 years or older.
Interventions: None.
Measurements and Main Results: A total of 11,648, 38,532, and 165,125 index admissions were analyzed from Post Intensive Care Risk-Adjusted Alerting and Monitoring, Medical Information Mart for Intensive Care III and electronic ICU databases respectively. In all three cohorts, conditional survival declined over the first 5–10 days after ICU admission and changed little thereafter. In patients greater than or equal to 75 years old conditional survival continued to decline with increasing length of stay.
Conclusions: After an initial period of 5–10 days, probability of future survival does not decrease with increasing length of stay in unselected patients admitted to ICUs. These findings were consistent between the three populations and suggest that a prolonged admission to an ICU is not a reason for a pessimism in younger patients but may indicate a poor prognosis in the older population.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 409.7KB, Terms of use)
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- Publisher copy:
- 10.1097/CCM.0000000000004082
Authors
- Publisher:
- Lippincott, Williams and Wilkins
- Journal:
- Critical Care Medicine More from this journal
- Publication date:
- 2019-11-18
- Acceptance date:
- 2018-09-28
- DOI:
- EISSN:
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1530-0293
- ISSN:
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0090-3493
- Keywords:
- Pubs id:
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pubs:1058215
- UUID:
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uuid:d0a8cff1-08b8-4d00-a8bf-5de0eb6b1b99
- Local pid:
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pubs:1058215
- Source identifiers:
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1058215
- Deposit date:
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2019-09-28
Terms of use
- Copyright holder:
- Society of Critical Care Medicine
- Copyright date:
- 2019
- Notes:
- © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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