Long-term mortality of patients discharged from the hospital after successful critical care in the ICU in Korea: a retrospective observational study in a single tertiary care teaching hospital

Na, Se Hee; Shin, Cheung Soo; Kim, Gwan Ho; Kim, Jae-Hoon; Lee, Jong Seok

doi:10.4097/kja.d.18.00275

Cited by 8 publications

(13 citation statements)

References 30 publications

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“…We observed no association between the presence of comorbidities and post-discharge mortality-a surprising nding, particularly in light of previously published research that has rmly established such an association [16,23,24]. Patients with malignancies have been found that have 2.3 higher chances of death one year post-discharge from the ICU [10] just like patients with hematologic disease and solid tumours [23]. The difference between our ndings and existing literature could be due to the small sample size in our study which may have affected the ability of the study to detect small effect sizes.…”

Section: Discussionsupporting

confidence: 42%

“…Approximately half of ICU survivors suffer lasting physical, cognitive or psychiatric complications with a post-ICU functional status often below premorbid status resulting in cognitive impairment and decline in performance of activities of daily living (ADLs) [7,8]. Predictors of these outcomes include older age, comorbidities, APACHE II score, mechanical ventilation and other organ support, the severity of illness at ICU admission, pre-admission disability, and frailty [9][10][11][12]. Recognition of these complications is most apparent when patients attempt to resume normal community roles [13,14].…”

Section: Introductionmentioning

confidence: 99%

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Long-term Outcomes and Associated factors among Intensive Care Unit Survivors in a Low- income Country: A Multicenter Prospective Cohort study

Matovu.,

Sendagire,

Luggya

et al. 2024

Preprint

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Background Post-ICU survivors face higher mortality and often require costly rehabilitation or palliative care, such as occupational therapy, physiotherapy and hospice yet there is a lack of data quantifying the demand for these services, particularly in developing countries like Uganda. Moreover, a critical knowledge gap persists regarding long-term outcomes and predictors among post-ICU survivors. Our study aimed to ascertain the 90-day mortality rate, evaluate functional status, and identify risk factors for mortality among patients discharged from three tertiary hospital ICUs in Uganda. Methods We conducted a multicenter prospective cohort study that tracked 121 adult patients discharged from three tertiary hospital intensive care units for three months. Data collection utilized open data kit (ODK) software. Follow-up involved telephone assessments by trained research assistants on days 30, 60, and 90 post-discharge, evaluating vital and physical functional status with the Karnofsky Performance status tool. The study's primary outcomes included mortality at 90 days post-ICU discharge and the physical functional status of ICU survivors. Cox regression analysis using Stata version 15 was used to determine the factors associated with 90-day mortality. Results A total of 18/121 died following discharge from the ICU giving a mortality rate of 14.9% (95% CI: 9.5%- 22.5%). Approximately 36.36% achieved a normal physical functional status. Factors associated with 90-day mortality included raised intracranial pressure (HR 1.92, 95% CI 1.763–2.787, p = 0.04), acute kidney injury (HR 4.13, 95% CI 2.163–7.890, p < 0.001) and renal replacement therapy (HR 3.34, 95% CI 2.210–5.060, p < 0.001) Conclusion High 90-day mortality is observed in post-ICU patients, particularly those with elevated intracranial pressure, acute kidney injury, and prior renal replacement therapy. The fact that nearly two-thirds of patients fail to attain a normal functional status after 90 days highlights the need for post-ICU rehabilitation services.

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Section: Discussionsupporting

confidence: 42%

Section: Introductionmentioning

confidence: 99%

Long-term Outcomes and Associated factors among Intensive Care Unit Survivors in a Low- income Country: A Multicenter Prospective Cohort study

Matovu.,

Sendagire,

Luggya

et al. 2024

Preprint

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“…Os resultados aqui apresentados indicaram também que os idosos têm uma chance de 5,85 vezes maior de serem submetidos a traqueostomia do que os adultos. Ao encontro desses dados, Dolin 24 . afirma que os idosos tem maior chance de evolução para formas graves quando acometidos por doenças do sistema respiratório, uma vez que possuem diminuição da complacência pulmonar, diminuição da força muscular respiratória, diminuição da imunidade celular e diminuição da resposta das células B a novos antígenos.…”

Section: Discussionunclassified

Tendência temporal da utilização da traqueostomia em pacientes hospitalizados pelo Sistema Único de Saúde no Brasil no período de 2011 a 2020

NAZARIO

Magajewski

PIZZOL

et al. 2022

Rev. Col. Bras. Cir.

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RESUMO Objetivo: analisar a tendência temporal da utilização da traqueostomia em pacientes hospitalizados pelo Sistema Único de Saúde no Brasil no período de 2011 a 2020. Método: estudo observacional de tipo ecológico, com abordagem quantitativa, e incluiu a população brasileira com 20 anos ou mais que, internadas pelo Sistema Único de Saúde, tiveram registro de realização do procedimento de traqueostomia em qualquer momento da hospitalização. Resultados: das 113.569.570 hospitalizações estudadas, foram identificadas 172.456 traqueostomias realizadas no Brasil (0,15%). A taxa média de realização deste procedimento apresentou tendência de queda no período estudado. A maior taxa média de traqueostomia foi encontrada na Região Sul, e a faixa etária mais afetada foi a dos 80 anos ou mais. A taxa média de traqueostomia no sexo masculino foi de 1,8 vezes maior do que no sexo feminino. As principais causas associadas à realização de traqueostomia foram as patologias respiratórias, oncológicas e decorrentes de causas externas, sendo que as causas respiratórias contribuíram com 73% do total de procedimentos estudados. Conclusões: as taxas médias de mortalidade e letalidade das internações com traqueostomia no Brasil foram de 3,36 e 28,57%, mas apresentaram tendência de redução no período.

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mentioning

confidence: 93%

“…We have read the study on the long-term prognosis of patients after discharge from the intensive care unit (ICU) [1]. The article reaffirms the existence of factors that cannot be modified during the ICU stay; however, other aspects may improve survival after discharge, such as preventative measures.…”

mentioning

confidence: 93%

In response to Na et al.’s long-term mortality of patients discharged from the hospital after successful critical care: do we need more comprehensive data?

Esquinas

Karim

Mina

2020

Korean J Anesthesiol

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We have read the study on the long-term prognosis of patients after discharge from the intensive care unit (ICU) [1]. The article reaffirms the existence of factors that cannot be modified during the ICU stay; however, other aspects may improve survival after discharge, such as preventative measures.The authors have discussed some of the limitations; however, there are additional aspects that we feel are worthy of discussing for better acceptance of the results. Firstly, although the 1-year mortality data reported in the study is congruous with international data, we believe that the reported mortality is probably lower. The exclusion of 827 patients who died in the hospital or had a terminal prognosis from the final analysis is a potential bias. Furthermore, 673 patients were also excluded because of ICU readmission, the number of patients readmitted within 1 year and the mortality data are unclear. Therefore, the data represent the long-term outcome of ICU survivals and not patients who required ICU care.Secondly, in comparison with the 1-year mortality data from 2006 to 2011, the 5-year mortality data presented only a sample size as the study was performed on only 831 patients from 2006 to 2007.Thirdly, the authors did not report the impact of ICU length of stay, treatment modalities such as the length of mechanical ventilation weaning modalities, tracheostomy, presence of specialized weaning units [2], and renal replacement on survival. No data on the quality of life of survivors were mentioned, including transfer to long-term care facilities or receiving in-home mechanical ventilation during the follow-up period [3]. It is recommended to consider this data since it is a critical factor that can affect the long-term outcome after discharge. Similarly, as the authors evaluated the long-term outcome, information and analysis of the parameters related to the quality of life at discharge that can be modified would provide essential information. We believe that it could be more informative if the authors considered the evaluation of predictive models of survival [4].Lastly, the study is a single-center, university-based study and does not reflect mortality among ICU in Korea. The data cannot be generalized to entire Korea due to different standard of care and implementation/adherence of protocols. This data can be helpful to minimize institutional variation in discharge protocols [5]. We applaud the authors for their work with a relatively correct sample size and multivariate analysis of factors and Letter to the Editor Korean J Anesthesiol 2020;73(2):171-172 https://doi.

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Long-term mortality of patients discharged from the hospital after successful critical care in the ICU in Korea: a retrospective observational study in a single tertiary care teaching hospital

Cited by 8 publications

References 30 publications

Long-term Outcomes and Associated factors among Intensive Care Unit Survivors in a Low- income Country: A Multicenter Prospective Cohort study

Long-term Outcomes and Associated factors among Intensive Care Unit Survivors in a Low- income Country: A Multicenter Prospective Cohort study

Tendência temporal da utilização da traqueostomia em pacientes hospitalizados pelo Sistema Único de Saúde no Brasil no período de 2011 a 2020

In response to Na et al.’s long-term mortality of patients discharged from the hospital after successful critical care: do we need more comprehensive data?

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