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Title: Patient characteristics, ICU-specific supports, complications, and outcomes of persistent critical illness.
Austin Authors: Jeffcote, Toby;Foong, Monica;Gold, Grace ;Glassford, Neil;Robbins, Raymond J ;Iwashyna, Theodore J;Darvall, Jai;Bagshaw, Sean M;Bellomo, Rinaldo 
Affiliation: School of Medicine, University of Melbourne, Parkville, Melbourne, VIC, Australia
Business Intelligence
Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
Intensive Care
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Prahran, VIC 3004, Australia
Department of Medicine and Institute for Social Research, University of Michigan, USA; VA Center for Clinical Management Research, VA Ann Arbor Health Healthcare System, Ann Arbor, MI, USA
Issue Date: Dec-2019
Date: 2019-08-20
Publication information: Journal of Critical Care 2019; 54: 250-255
Abstract: The primary objective was to identify the proportion of patients on mechanical ventilation (MV) beyond day 10, the recently defined time of onset of Persistent Critical Illness (PerCI). The secondary objective was to identify underlying diagnoses, intensive care unit (ICU) based therapies, relevant complications, and outcomes of patients with PerCI. 100 PerCI patients and 100 age, sex, mechanical ventilation for >24 h, acute physiology and chronic health score (APACHE III) and co-morbidity score-matched controls. The maximum proportion of PerCI patients requiring invasive MV beyond day 10 was 66%. PerCI patients were more likely to have respiratory, septic, or neurosurgical admission diagnoses (p = .01). In the first 10 ICU days, they received multiple types of ICU-based treatments for longer duration and had a higher incidence rate of ventilator-associated pneumonia (VAP) (p = .008). Hospital discharge destination differed significantly (p≤.001), with greater mortality (34% vs. 22%) and discharge to chronic care facility (11% vs. 0%). Mechanical ventilation beyond day 10 affected only two thirds of PerCI patients. However, VAP was a key complication in such patients. Discharge to chronic care facilities and hospital mortality were more common in PerCI patients.
DOI: 10.1016/j.jcrc.2019.08.023
Journal: Journal of Critical Care
PubMed URL: 31630075
Type: Journal Article
Subjects: Delirium
Intensive care
Mechanical ventilation
Persistent critical illness
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