[Post-Intensive Care Unit mortality and related prognostic factors in a cohort of critically ill patients with multi-organ dysfunction]

Med Clin (Barc). 2013 Jun 4;140(11):479-86. doi: 10.1016/j.medcli.2012.09.043. Epub 2013 Jan 18.
[Article in Spanish]

Abstract

Background and objective: To assess the post-Intensive Care Unit (ICU) mortality (in-hospital and one year after hospital discharge) and the associated factors.

Patients and method: Cohort design in medical-surgical patients with multi-organ dysfunction syndrome (MODS) during the first 24h of admission to ICU. We recorded the following data: personal background, functional general situation, general information about admission to ICU, hospital stay and contact by phone after one year of hospital discharge. We registered mortality at the follow-up at anytime. Cox regression was performed to evaluate mortality factors.

Results: Five hundred and forty five patients were recruited. During the study period 256 patients (52.9%) died; out of them 29.5% in ICU; 14.8% of 384 patients transferred to the ward died. Of 327 discharged patients, 266 (81.3%) were contacted; 14.3% of those had died. In-hospital death-related factors were age (odds ratio [OR] 1.04; 95% confidence interval [95% CI] 1.02-1.06; P<.01) and a decreased functional general status (OR 1.7; 95% CI 1.1-2.9; P<.05). Post-hospitalisation mortality-related variables were: diminished functional general status (OR 2.42; 95% CI 1.23-4.75; P<.01) and readmission after discharge from hospital (1.45 OR; 95% CI 1.19-1.76; P<.001).

Conclusions: Patients admitted for a medical-surgical MODS presented a mortality of 52.9% within one year. The factors influencing hospital mortality are age and a generally diminished functional status, both being not modifiable factors. After discharge, the decreased general functional status remained central along with the re-hospitalisation.

Publication types

  • English Abstract

MeSH terms

  • Aftercare
  • Aged
  • Critical Illness / mortality*
  • Diagnosis-Related Groups
  • Female
  • Follow-Up Studies
  • Hospital Mortality
  • Humans
  • Intensive Care Units*
  • Kaplan-Meier Estimate
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Multiple Organ Failure / mortality*
  • Patient Discharge
  • Patient Transfer
  • Proportional Hazards Models
  • Severity of Illness Index
  • Spain / epidemiology
  • Tertiary Care Centers / statistics & numerical data