International Journal of Critical Illness and Injury Science

LETTER TO THE EDITOR
Year
: 2014  |  Volume : 4  |  Issue : 4  |  Page : 320--321

Long-term outcome factors associated with prolonged admission to the ICU


Luciano Santana-Cabrera1, Rosa Lorenzo Torrent1, Manuel Sánchez-Palacios1, Cristina Rodríguez-Escot1, Josefa D Martín-Santana2, Juan Ramón Hernández Hernández1,  
1 Intensive Care Unit, Universitary Hospital Insular of Gran Canaria, Las Palmas of Gran Cana, Spain
2 University of Las Palmas of Gran Canaria, Las Palmas of Gran Canaria, Spain

Correspondence Address:
Dr. Luciano Santana-Cabrera
Avenida Marítima del Sur s/n., Las Palmas of Gran Canaria, Canary Islands-35016
Spain




How to cite this article:
Santana-Cabrera L, Torrent RL, Sánchez-Palacios M, Rodríguez-Escot C, Martín-Santana JD, Hernández JR. Long-term outcome factors associated with prolonged admission to the ICU.Int J Crit Illn Inj Sci 2014;4:320-321


How to cite this URL:
Santana-Cabrera L, Torrent RL, Sánchez-Palacios M, Rodríguez-Escot C, Martín-Santana JD, Hernández JR. Long-term outcome factors associated with prolonged admission to the ICU. Int J Crit Illn Inj Sci [serial online] 2014 [cited 2022 Dec 2 ];4:320-321
Available from: https://www.ijciis.org/text.asp?2014/4/4/320/147558


Full Text

Sir,

The influence of prolonged intensive care unit (ICU) stay in prognosis has been studied by several authors and some found higher mortality among patients with prolonged stay compared to those who require a shorter stay in the ICU, although some authors found in their population a substantial number of these patients survive long-term. [1],[2] Some authors define prolonged length of stay of their patients to those that exceed the 95 th percentile of the overall stay, although most of the work referred to it when >14 days and other authors refer to stays >28 days. [2],[3],[4]

The objective of this study was to analyze the factors that can influence survival a year after hospital discharge associated with prolonged admission to the ICU.

We retrospectively reviewed data collected prospectively on patients admitted to the ICU from January 2004 to December 2010, with prolonged stay (>14 days), according to their survival 1 year later. During the study; 6,069 patients were admitted to the ICU. Seven hundred and seven (11.6%) stayed in ICU >14 days, and consumed a large proportion of ICU bed days (55.5%), 411 (58.13%) patients left hospital alive, and we only know their year survival to 297 patients (72.26%) [Table 1]. A logistic regression was performed to predict 1 year survival of patients with prolonged stay in ICU. From results shown in table, patients with prolonged ICU stay have a better prognosis after a year when they have a shorter stay in the ICU and lower Acute Physiology and Chronic Health Evaluation (APACHE) II at admission. With this regression we predict 100% survival in the group of patients who left hospital alive, but it is not possible to predict the survival of the group who died (0.0%). In statistical terms, this means that the model is able to predict correctly 92.0% of patients with prolonged stay admitted in ICU. [Figure 1] shows the receiver operating characteristic curve (ROC) of survival after a year, for the previous logistic regression model, for long stay patients in ICU. The area under the curve was 0.736.{Figure 1}{Table 1}

In conclusion, although the group of patients with prolonged stay is only a small percentage of ICU admissions, but they consume a large proportion of ICU bed days, comparable with data reported in the literature which range from 28 to 53% of available bed days. [5],[6] The factors that best define 1 year survival are length of stay in ICU and APACHE II at admission.

References

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