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Long-term survival after intensive care : A retrospective cohort study

Kristinsdottir, Eyrun A LU ; Long, Thorir E LU ; Sigvaldason, Kristinn ; Karason, Sigurbergur ; Sigurdsson, Gisli H and Sigurdsson, Martin I (2020) In Acta Anaesthesiologica Scandinavica 64. p.75-84
Abstract

Background Limited data exist on long-term survival of patients requiring admission to intensive care units (ICUs). The aim of this study was to investigate long-term survival of ICU patients in Iceland and assess changes over a 15-year period. Methods Data were collected on age, gender, admission cause, length of stay, comorbidities, mechanical ventilation and survival of patients 18 years and older admitted to the ICUs in Landspitali during 2002-2016. Long-term survival of patients surviving more than 30 days from admission was estimated and its predictors assessed with Cox regression analysis. Long-term survival was compared to the survival of an age- and gender-matched reference group from the general population. Results Of 15 832... (More)

Background Limited data exist on long-term survival of patients requiring admission to intensive care units (ICUs). The aim of this study was to investigate long-term survival of ICU patients in Iceland and assess changes over a 15-year period. Methods Data were collected on age, gender, admission cause, length of stay, comorbidities, mechanical ventilation and survival of patients 18 years and older admitted to the ICUs in Landspitali during 2002-2016. Long-term survival of patients surviving more than 30 days from admission was estimated and its predictors assessed with Cox regression analysis. Long-term survival was compared to the survival of an age- and gender-matched reference group from the general population. Results Of 15 832 ICU admissions, 55% was medical, 38% was surgical and 7% was due to trauma. The 5-year survival of medical, surgical and trauma patients was 66%, 76% and 92% respectively. Significant survival differences were found between admission subgroups. Higher age and comorbidity burden was related to decreased survival in all patient groups. After correcting for age, gender, comorbidities, length of ICU stay and mechanical ventilation, patient survival improved during the study period only for patients admitted for infections. There was a high variability in the estimated time point where the ICU admission had no residual effect on survival. Conclusions Long-term survival of ICU patients is substantially decreased compared to the general population, but varies based on admission causes. Improved long-term survival of patients admitted with infections could be explained by earlier detection and improved treatment of septic shock.

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author
; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Adult, Age Factors, Aged, Cohort Studies, Critical Care/statistics & numerical data, Female, Follow-Up Studies, Humans, Iceland/epidemiology, Length of Stay/statistics & numerical data, Male, Middle Aged, Respiration, Artificial/statistics & numerical data, Retrospective Studies, Sex Factors, Survival Analysis, Time
in
Acta Anaesthesiologica Scandinavica
volume
64
pages
75 - 84
publisher
Wiley-Blackwell
external identifiers
  • pmid:31529483
  • scopus:85074083193
ISSN
0001-5172
DOI
10.1111/aas.13475
language
English
LU publication?
no
additional info
© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
id
9c68b21b-b0d0-4da3-ab87-fbfe2b8e6bc9
date added to LUP
2024-12-05 16:10:59
date last changed
2025-01-17 07:32:55
@article{9c68b21b-b0d0-4da3-ab87-fbfe2b8e6bc9,
  abstract     = {{<p>Background Limited data exist on long-term survival of patients requiring admission to intensive care units (ICUs). The aim of this study was to investigate long-term survival of ICU patients in Iceland and assess changes over a 15-year period. Methods Data were collected on age, gender, admission cause, length of stay, comorbidities, mechanical ventilation and survival of patients 18 years and older admitted to the ICUs in Landspitali during 2002-2016. Long-term survival of patients surviving more than 30 days from admission was estimated and its predictors assessed with Cox regression analysis. Long-term survival was compared to the survival of an age- and gender-matched reference group from the general population. Results Of 15 832 ICU admissions, 55% was medical, 38% was surgical and 7% was due to trauma. The 5-year survival of medical, surgical and trauma patients was 66%, 76% and 92% respectively. Significant survival differences were found between admission subgroups. Higher age and comorbidity burden was related to decreased survival in all patient groups. After correcting for age, gender, comorbidities, length of ICU stay and mechanical ventilation, patient survival improved during the study period only for patients admitted for infections. There was a high variability in the estimated time point where the ICU admission had no residual effect on survival. Conclusions Long-term survival of ICU patients is substantially decreased compared to the general population, but varies based on admission causes. Improved long-term survival of patients admitted with infections could be explained by earlier detection and improved treatment of septic shock.</p>}},
  author       = {{Kristinsdottir, Eyrun A and Long, Thorir E and Sigvaldason, Kristinn and Karason, Sigurbergur and Sigurdsson, Gisli H and Sigurdsson, Martin I}},
  issn         = {{0001-5172}},
  keywords     = {{Adult; Age Factors; Aged; Cohort Studies; Critical Care/statistics & numerical data; Female; Follow-Up Studies; Humans; Iceland/epidemiology; Length of Stay/statistics & numerical data; Male; Middle Aged; Respiration, Artificial/statistics & numerical data; Retrospective Studies; Sex Factors; Survival Analysis; Time}},
  language     = {{eng}},
  pages        = {{75--84}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Anaesthesiologica Scandinavica}},
  title        = {{Long-term survival after intensive care : A retrospective cohort study}},
  url          = {{http://dx.doi.org/10.1111/aas.13475}},
  doi          = {{10.1111/aas.13475}},
  volume       = {{64}},
  year         = {{2020}},
}