Description

Zampieri et al identified factors associated with a prolonged stay in the intensive care unit. These can help to identify a patient who may require more aggressive management or consume more resources. The authors are from Hospital Alemao Oswaldo Cruz and the University of Sao Paulo in Brazil.


 

Patient:adult admitted to ICU in Sao Paulo

 

Outcome: prolonged ICU admission (> 14 days)

 

Factors on admission associated with a prolonged admission:

(1) greater illness severity based on SAPS3 (odds ratio 1.03 per unit of score)

(2) need for respiratory support (mechanical ventilation > noninvasive ventilation > no support required)

(3) worse performance status (disability)

(4) fever on admission

(5) admission from location other than operating room (emergency department, hospital ward, home health, other hospital)

(6) readmission

(7) intracranial mass effect

(8) severe COPD (on oxygen therapy)

 

where:

• The use of pressors was associated with early mortality.

• Performance status (PS) was based on ECOG scale with ECOG 0 to 2 = PS0 (no disability), ECOG 3 = PS1 (limited self-care) and ECOG 4 = PS2 (total disability).

• Readmission is presumed ICU readmission but ambiguous.

 


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