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Summary Patients with a long stay in the intensive care unit because of chronic critical illness consume many resources, and yet their outcome may be poor. We evaluated the long‐term outcome of patients spending more than 60 days in the intensive care unit. We performed a retrospective cohort and prospective follow‐up study of 78 patients staying more than 60 days in the 19–26 bed mixed intensive care unit of a university hospital from November 1995 to January 2003. The mortality in the intensive care unit was 38%; at 1 and 5 years it was 56% and 67%, respectively. Advanced age, prior pulmonary disease, long duration of renal replacement therapy, a low oxygenation ratio and platelet count and high Simplified Acute Physiology Score II and Sequential Organ Failure Assessment scores on day 60 influenced long‐term mortality. A Simplified Acute Physiology Score II of 50 or a Sequential Organ Failure Assessment score of 8 or higher was associated with 100% mortality during follow‐up. The overall 5‐year survival rate of 33% suggests that prolonged intensive care may be worth the effort in certain patients.

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