OBJECTIVE: Treatment of surgical patients in intensive care unit (ICU) comes along with major disadvantages, which have to be justified by some acceptable short- and long-term outcomes. Short-term effects of treatment in ICU have been well-documented. The aims of this study were to quantify the long-term survival of more than 10 years' follow-up of a large cohort of patients admitted to a surgical ICU and to investigate the effects of age, gender, and underlying disease on this long-term survival. PATIENTS/ METHODS: Of all surgical patients admitted to the ICU of the St Elisabeth Hospital between 1995 and 2000, patient characteristics, disease category, APACHE II score, and survival were prospectively registered. A follow-up with a mean of 8 years after discharge was achieved. The independent association of multiple covariates was done using cox proportional hazard analysis. RESULTS: Of the 1822 patients included, 936 (51%) had died within 11 years and 52 patients were lost to follow-up. Overall ICU and in-hospital mortality were 11% and 16%, respectively. Age, gender, APACHE II score, the need for dialysis, and surgical classification were independently associated with long-term survival. Mortality increased with age of admittance to the ICU (hazard ratio, 1.058), whereas female patients had a lower chance to die (hazard ratio, 0.793). However, the preadmission disease did not influence long-term outcome. Long-term mortality rates in various surgical classification groups varied between 29% for trauma and 80% for gastrointestinal patients. In gastrointestinal, oncological, general surgical, and/or high-aged patients, a negative effect on mortality persisted beyond 5 years. The mortality ratio was increased twofold in comparison to the general population (51% vs 27%). CONCLUSION: Ten years after ICU discharge, survival was only 50%. After ICU treatment, survival follows distinct patterns in which age, gender, surgical classification, the need of dialysis, and APACHE II score are independent determinants, and long lasting.
OBJECTIVE: Treatment of surgical patients in intensive care unit (ICU) comes along with major disadvantages, which have to be justified by some acceptable short- and long-term outcomes. Short-term effects of treatment in ICU have been well-documented. The aims of this study were to quantify the long-term survival of more than 10 years' follow-up of a large cohort of patients admitted to a surgical ICU and to investigate the effects of age, gender, and underlying disease on this long-term survival. PATIENTS/ METHODS: Of all surgical patients admitted to the ICU of the St Elisabeth Hospital between 1995 and 2000, patient characteristics, disease category, APACHE II score, and survival were prospectively registered. A follow-up with a mean of 8 years after discharge was achieved. The independent association of multiple covariates was done using cox proportional hazard analysis. RESULTS: Of the 1822 patients included, 936 (51%) had died within 11 years and 52 patients were lost to follow-up. Overall ICU and in-hospital mortality were 11% and 16%, respectively. Age, gender, APACHE II score, the need for dialysis, and surgical classification were independently associated with long-term survival. Mortality increased with age of admittance to the ICU (hazard ratio, 1.058), whereas female patients had a lower chance to die (hazard ratio, 0.793). However, the preadmission disease did not influence long-term outcome. Long-term mortality rates in various surgical classification groups varied between 29% for trauma and 80% for gastrointestinalpatients. In gastrointestinal, oncological, general surgical, and/or high-aged patients, a negative effect on mortality persisted beyond 5 years. The mortality ratio was increased twofold in comparison to the general population (51% vs 27%). CONCLUSION: Ten years after ICU discharge, survival was only 50%. After ICU treatment, survival follows distinct patterns in which age, gender, surgical classification, the need of dialysis, and APACHE II score are independent determinants, and long lasting.
Authors: Tony C Pang; Calista Spiro; Tim Ramacciotti; Julian Choi; Martin Drummond; Edmund Sweeney; Jaswinder S Samra; Thomas J Hugh Journal: HPB (Oxford) Date: 2014-08-26 Impact factor: 3.647
Authors: Anne C Mosenthal; David E Weissman; J Randall Curtis; Ross M Hays; Dana R Lustbader; Colleen Mulkerin; Kathleen A Puntillo; Daniel E Ray; Rick Bassett; Renee D Boss; Karen J Brasel; Margaret Campbell; Judith E Nelson Journal: Crit Care Med Date: 2012-04 Impact factor: 7.598
Authors: Tim K Timmers; Joost A van Herwaarden; Gert-Jan de Borst; Frans L Moll; Luke P H Leenen Journal: World J Surg Date: 2013-12 Impact factor: 3.352
Authors: Verena Martini; Ann-Kathrin Lederer; Claudia Laessle; Frank Makowiec; Stefan Utzolino; Stefan Fichtner-Feigl; Lampros Kousoulas Journal: Crit Care Res Pract Date: 2017-07-30