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Can ICU admission be predicted?
Critical Care volume 14, Article number: P414 (2010)
After intensive care (IC), patients report poor health-related quality of life (HRQoL). Many factors affect the patients and influence the HRQoL after discharge. One of these factors is the patient's health status before the critical care period. In a previous study we found that the IC patients have a high frequency of pre-existing diseases. However, it is unknown to what extent these pre-existing diseases affect the consumption of hospital resources (measured as days as inpatients) in the time period before admission to the ICU and during the years following it. The consumption prior to the ICU event may also be claimed to herald an increased risk for a later ICU admittance? The aim of this study was to examine the hospital care consumption of former ICU patients 3 years prior to and 3 years after the intensive care period. This was examined in relation to the pre-existing health status.
Two mixed ICUs from hospitals in two cities in Sweden. A question naire including previous illnesses and HRQoL scale SF-36 were sent 6, 12, 24 and 36 months after discharge from the ICU and hospital. All adult patients with an ICU stay >24 hours were included. The institutional care consumption was assessed from the regional hospital databases
Six hundred and thirteen patients were included in the study. Of these 73% had pre-existing diseases. There were no significant differences between the previously healthy patients apart from younger age (mean age 52 (SD 20.7) vs 60 (SD 17.3)) and lower APACHE II scores (13.4 (SD 7.2) vs 16.4 (SD 7.7)) compared with patients with pre-existing disease. The ICU patients with pre-existing disease consumed significantly more hospital resources 3, 2 and 1 year prior to admission to the ICU, and up to 3 years after discharge both regarding quantity of care (number of visits) (P = 0.001), length of stay (P = 0.001), and cost (P = 0.002). There were no significant differences in quantity of care, length of stay, or costs during the ICU period. Most importantly there was a significant increasing trend for the 3 years prior to the ICU event.
Patients with co-morbidities have a significant consumption of hospital resources both prior to and after the ICU period. Interestingly, this consumption increased prior to the ICU event and seemed to herald the future deterioration of the patients. Further investigations should be made to examine to what extent ICU admissions can be predicted based on these data.
Orwelius L, et al.: Crit Care Med. 2005, 33: 1557-1564. 10.1097/01.CCM.0000168208.32006.1C
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Orwelius, L., Fredriksson, M., Bäckman, C. et al. Can ICU admission be predicted?. Crit Care 14, P414 (2010). https://doi.org/10.1186/cc8646
- Intensive Care Patient
- Hospital Resource
- Care Period
- HRQoL Scale
- Future Deterioration