Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/27057
Title: Predictors of death and new disability after critical illness: a multicentre prospective cohort study.
Austin Authors: Higgins, A M;Serpa Neto, Ary ;Bailey, M;Barrett, J;Bellomo, Rinaldo ;Cooper, D J;Gabbe, B J;Linke, N;Myles, P S;Paton, M;Philpot, S;Shulman, M;Young, M;Hodgson, C L
Affiliation: Intensive Care Unit, Cabrini Health, Melbourne, VIC, Australia
Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
Intensive Care Unit, Epworth Healthcare, Melbourne, VIC, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
Department of Intensive Care and Hyperbaric Medicine, The Alfred, Melbourne, VIC, Australia
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, VIC, 3004, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Department of Anaesthesiology and Perioperative Medicine, The Alfred, Melbourne, VIC, Australia
Department of Physiotherapy, Monash Health, Melbourne, VIC, Australia
Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia
Intensive Care
Issue Date: Jul-2021
Date: 2021-06-05
Publication information: Intensive Care Medicine 2021; 47(7): 772-781
Abstract: This study aimed to determine the prevalence and predictors of death or new disability following critical illness. Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h of mechanical ventilation. The primary outcome was death or new disability at 6 months, with new disability defined by a 10% increase in the WHODAS 2.0. Of 628 patients with the primary outcome available (median age of 62 [49-71] years, 379 [61.0%] had a medical admission and 370 (58.9%) died or developed new disability by 6 months. Independent predictors of death or new disability included age [OR 1.02 (1.01-1.03), P = 0.001], higher severity of illness (APACHE III) [OR 1.02 (1.01-1.03), P < 0.001] and admission diagnosis. Compared to patients with a surgical admission diagnosis, patients with a cardiac arrest [OR (95% CI) 4.06 (1.89-8.68), P < 0.001], sepsis [OR (95% CI) 2.43 (1.32-4.47), P = 0.004], or trauma [OR (95% CI) 6.24 (3.07-12.71), P < 0.001] diagnosis had higher odds of death or new disability, while patients with a lung transplant [OR (95% CI) 0.21 (0.07-0.58), P = 0.003] diagnosis had lower odds. A model including these three variables had good calibration (Brier score 0.20) and acceptable discriminative power with an area under the receiver operating characteristic curve of 0.76 (95% CI 0.72-0.80). Less than half of all patients mechanically ventilated for more than 24 h were alive and free of new disability at 6 months after admission to ICU. A model including age, illness severity and admission diagnosis has acceptable discriminative ability to predict death or new disability at 6 months.
URI: https://ahro.austin.org.au/austinjspui/handle/1/27057
DOI: 10.1007/s00134-021-06438-7
ORCID: 0000-0001-9002-2075
Journal: Intensive Care Medicine
PubMed URL: 34089063
Type: Journal Article
Subjects: Disability
Intensive care
Mechanical ventilation
Outcome prediction
Recovery
Appears in Collections:Journal articles

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