OBJECTIVE: To assess the predictive ability of preillness and illness variables, impact of care, and discharge variables on the post-intensive care mortality. SETTING AND PATIENTS: 5,805 patients treated with high intensity of care in 89 ICUs in 12 European countries (EURICUS-I study) surviving ICU stay. METHODS: Case-mix was split in training sample (logistic regression model for post-ICU mortality: discrimination assessed by area under ROC curve) and in testing sample. Time to death was studied by Cox regression model validated with bootstrap sampling on the unsplit case-mix. RESULTS: There were 5,805 high-intensity patients discharged to ward and 423 who died in hospital. Significant odds ratios were observed for source of admission, medical/surgical unscheduled admission, each year age, each SAPSII point, each consecutive day in high-intensity treatment, and each NEMS point on the last ICU day. Time to death in ward was significantly shortened by different source of admission; age over 78 years, medical/unscheduled surgical admission; SAPSII score without age, comorbidity and type of admission over 16 points; more than 2 days in high-intensity treatment; all days spent in high treatment; respiratory, cardiovascular, and renal support at discharge; and last ICU day NEMS higher than 27 points CONCLUSIONS: Worse outcome is associated with the physiological reserve before admission in the ICU, type of illness, intensity of care required, and the clinical stability and/or the grade of nursing dependence at discharge

Determinants of post-intensive care mortality in high-level treated critically ill patients / G. Iapichino, A. Morabito, G. Mistraletti, L. Ferla, D. Radrizzani, D.R. Miranda. - In: INTENSIVE CARE MEDICINE. - ISSN 0342-4642. - 29:10(2003 Oct), pp. 1751-1756.

Determinants of post-intensive care mortality in high-level treated critically ill patients

G. Iapichino
Primo
;
A. Morabito
Secondo
;
G. Mistraletti;
2003-10

Abstract

OBJECTIVE: To assess the predictive ability of preillness and illness variables, impact of care, and discharge variables on the post-intensive care mortality. SETTING AND PATIENTS: 5,805 patients treated with high intensity of care in 89 ICUs in 12 European countries (EURICUS-I study) surviving ICU stay. METHODS: Case-mix was split in training sample (logistic regression model for post-ICU mortality: discrimination assessed by area under ROC curve) and in testing sample. Time to death was studied by Cox regression model validated with bootstrap sampling on the unsplit case-mix. RESULTS: There were 5,805 high-intensity patients discharged to ward and 423 who died in hospital. Significant odds ratios were observed for source of admission, medical/surgical unscheduled admission, each year age, each SAPSII point, each consecutive day in high-intensity treatment, and each NEMS point on the last ICU day. Time to death in ward was significantly shortened by different source of admission; age over 78 years, medical/unscheduled surgical admission; SAPSII score without age, comorbidity and type of admission over 16 points; more than 2 days in high-intensity treatment; all days spent in high treatment; respiratory, cardiovascular, and renal support at discharge; and last ICU day NEMS higher than 27 points CONCLUSIONS: Worse outcome is associated with the physiological reserve before admission in the ICU, type of illness, intensity of care required, and the clinical stability and/or the grade of nursing dependence at discharge
Critically ill; Death in ward; EURICUS-I; ICU discharge status; Level of care; Time to die
Settore MED/41 - Anestesiologia
Settore MED/41 - Anestesiologia
Settore MED/01 - Statistica Medica
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/66704
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