Prolonged ICU stay and its association with 1-year trauma mortality: An analysis of 19,000 American patients.
Am J Surg
; 218(1): 21-26, 2019 07.
Article
em En
| MEDLINE
| ID: mdl-30722934
ABSTRACT
INTRODUCTION:
Prior research on patients with traumatic injury suggests high in-hospital survivability. However, little is known about their long-term outcomes, especially in the context of a prolonged ICU length-of-stay (LOS). We sought to determine the association between prolonged ICU-LOS and 1-year survival in trauma patients.METHODS:
TRICARE claims data (2011-2015) were queried for trauma patients with an Injury Severity Scoreâ¯>â¯9. Risk-adjusted Cox models were used to determine the influence of prolonged ICU LOS on 1-year mortality.RESULTS:
Of 19,155 patients included, 40% were admitted to the ICU. The overall 1-year mortality was 3.9% and 4.7% in patients with ICU LOS >9 days. In the multivariable model older age (55-64 vs. 18-24 years) (HR 47.8, CI20.8-109.9), prior comorbidities (>1 vs. 0) (HR 2.6, CI 2.1-3.2), discharge disposition (transfer vs discharge) (HR 2.3 CI 1.7-3.1) and ICU-LOS (>7 vs. 1 days) (HR2.6, CI1.7-4.0) were associated with 1-year mortality.CONCLUSION:
Prolonged ICU-LOS is a risk factor for 1-year mortality in trauma patients. But an overall high survival (>96%) reinforces the justification for such use of the ICU in trauma patients when clinically necessary.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ferimentos e Lesões
/
Unidades de Terapia Intensiva
/
Tempo de Internação
/
Militares
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Surg
Ano de publicação:
2019
Tipo de documento:
Article