Description

Williams et al identified factors impacting long-term survival after discharge from the intensive care unit (ICU). These can help identify a patient who may benefit from more aggressive followup. The authors are from the University of Western Australia and several hospitals in Perth, Australia.


 

Factors affecting long-term survival:

(1) age of the patient

(2) number and severity of comorbid conditions

(3) acute physiology score (APS) on ICU admission (from the APACHE II score)

(4) newly diagnosed cancer

(5) reason for ICU admission

Factor

Impaired Long Term Survival (Hazard Ratio >= 2)

age

age >= 45 years, with effect increasing with the patient's age (maximum effect with age >= 75 years)

number and severity of comorbid conditions

Charlson Comorbidity Index >= 3

APS score

>= 15

newly diagnosed cancer

 

reason for admission

surgery, cardiac arrest

 

Other factors impacting survival (hazard ratio 1.50 - 1.99):

(1) maximum number of organ failures >= 3

(2) length of stay in the ICU >= 5 days

(3) other reasons for admission: sepsis, drug overdose or poisoning, non-traumatic brain disorder, medical disorder

(4) APS score 10 to 14

(5) Charlson Comorbidity Index 1 or 2

 

Someone who has been admitted for the ICU with a serious illness has an impaired long-term survival compared to someone of similar age, race and sex who has not been.

 


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