Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34378
Title: Nature and impact of in-hospital complications associated with persistent critical illness.
Austin Authors: Tseitkin, Boris;Mårtensson, Johan;Eastwood, Glenn M ;Brown, Alastair;Ancona, Paolo;Lucchetta, Luca;Iwashyna, Theodore J;Robbins, Raymond J ;Bellomo, Rinaldo 
Affiliation: Intensive Care
Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Australian and New Zealand Intensive Care Society Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Department of Intensive Care Medicine, Catholic University of the Sacred Heart, "A. Gemelli" University Hospital, Rome, Italy.
Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.;Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Administrative Informatics, Austin Hospital, Melbourne, VIC, Australia.
Australian and New Zealand Intensive Care Society Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.;School of Medicine, University of Melbourne, Melbourne, VIC, Australia.;Data Analytics Research and Evaluation (DARE) Centre, Austin Hospital and University of Melbourne, Melbourne, VIC, Australia.;Department of Intensive Care, Royal Melbourne Hospital, VIC, Australia.
Issue Date: Dec-2020
Date: 2023
Publication information: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine 2020-12; 22(4)
Abstract: Background: Persistent critical illness (PerCI) is defined as an intensive care unit (ICU) admission lasting ≥ 10 days. The in-hospital complications associated with its development are poorly understood. Aims: To test whether PerCI is associated with a greater prevalence, rate and specific types of in-hospital complications. Methods: Single-centre, retrospective, observational case-control study. Results: We studied 1200 patients admitted to a tertiary ICU from 2010 to 2015. Median ICU length of stay was 16 days (interquartile range [IQR], 12-23) for PerCI patients v 2.3 days (IQR, 1.1-3.7) for controls, and median hospital length of stay was 41 days (IQR, 22-75) v 8 days (IQR, 4-17) respectively. A greater proportion of PerCI patients received acute renal replacement therapy (37% v 6.8%) or underwent reintubation (17% v 1%) and/or tracheostomy (36% v 0.6%); P < 0.0001. Despite these complications, PerCI patients had similar hospital mortality (29% v 27%; P = 0.53). PerCI patients experienced a greater absolute number of complications (12.1 v 4.0 complications per patient; P < 0.0001) but had fewer exposure-adjusted complications (202 v 272 complications per 1000 hospital bed-days; P < 0.001) and a particularly high overall prevalence of specific complications. Conclusions: PerCI patients experience a higher prevalence, but not a higher rate, of exposure-adjusted complications. Some of these complications appear amenable to prevention, helping to define intervention targets in patients at risk of PerCI. Funding: Austin Hospital Intensive Care Trust Fund.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34378
DOI: 10.51893/2020.4.OA11
ORCID: 
Journal: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
Start page: 378
End page: 387
PubMed URL: 38046870
Type: Journal Article
Appears in Collections:Journal articles

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