Jean-Pierre Quenot1,2,3,4, Julie Helms5,6, Guylaine Labro7, Auguste Dargent8,9,10, Nicolas Meunier-Beillard11,12, Elea Ksiazek11,12, Pierre-Edouard Bollaert13, Guillaume Louis14, Audrey Large8, Pascal Andreu8, Christophe Bein15, Jean-Philippe Rigaud16, Pierre Perez17, Raphaël Clere-Jehl5,6, Hamid Merdji5,6, Hervé Devilliers11,18, Christine Binquet11, Ferhat Meziani5,6,19, Isabelle Fournel11. 1. Service de Médecine Intensive-Réanimation, CHU Dijon Bourgogne, 14 rue Paul Gaffarel, B.P 77908, 21079, Dijon Cedex, France. jean-pierre.quenot@chu-dijon.fr. 2. INSERM, U1231, Equipe Lipness, Dijon, France. jean-pierre.quenot@chu-dijon.fr. 3. LipSTIC LabEx, Fondation de coopération scientifique Bourgogne-Franche-Comté, Dijon, France. jean-pierre.quenot@chu-dijon.fr. 4. INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France. jean-pierre.quenot@chu-dijon.fr. 5. Hôpitaux universitaires de Strasbourg, Service de Réanimation, Nouvel Hôpital Civil, Strasbourg, France. 6. Université de Strasbourg (UNISTRA), Faculté de Médecine, Strasbourg, France. 7. Service de Réanimation Médicale, CHU de Besançon, Besançon, France. 8. Service de Médecine Intensive-Réanimation, CHU Dijon Bourgogne, 14 rue Paul Gaffarel, B.P 77908, 21079, Dijon Cedex, France. 9. INSERM, U1231, Equipe Lipness, Dijon, France. 10. LipSTIC LabEx, Fondation de coopération scientifique Bourgogne-Franche-Comté, Dijon, France. 11. INSERM, CIC 1432, Module Epidémiologie Clinique, Dijon, France. 12. DRCI, USMR, CHU Dijon Bourgogne, Dijon, France. 13. Service de Médecine Intensive-Réanimation, CHRU Central, Nancy, France. 14. Service de Réanimation Médicale, CH de Metz, Metz, France. 15. Service de Réanimation Polyvalente, CH de la Haute-Saône, Vesoul, France. 16. Service de Médecine Intensive Réanimation, CH de Dieppe, Dieppe, France. 17. Service de Réanimation Médicale, CHRU Brabois, Nancy, France. 18. Service de Médecine Interne et Maladies Systémiques, CHU Dijon Bourgogne, Dijon, France. 19. INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.
Abstract
BACKGROUND: The influence of socioeconomic status on patient outcomes is unclear. We assessed the impact of socioeconomic deprivation on severity of illness at intensive care unit (ICU) admission, and on the risk of death at 3 months after ICU admission. METHODS: The IVOIRE study was a prospective, observational, multicentre cohort study in the ICU of 8 participating hospitals in France, including patients aged ≥ 18 years admitted to the ICU and receiving at least one life support therapy for organ failure. The primary outcomes were severity at admission (assessed by SAPSII score), and mortality at 3 months. Socioeconomic data were obtained from interviews with patients or family. Deprivation was assessed using the EPICES score. RESULTS: Among 1294 patents included between 2013 and 2016, 629 (48.6%) were classed as deprived and differed significantly from non-deprived subjects in terms of sociodemographic characteristics and pre-existing conditions. The mean SAPS II score at admission was 50.1 ± 19.4 in deprived patients and 52.3 ± 17.3 in non-deprived patients, with no significant difference by multivariable analysis (β = - 1.85 [95% CI - 3.86; + 0.16, p = 0.072]). The proportion of death was 31.1% at 3 months, without significant differences between deprived and non-deprived patients, even after adjustment for confounders. CONCLUSIONS: Deprivation is frequent in patients admitted to the ICU and is not associated with disease severity at admission, or with mortality at 3 months between deprived and non-deprived patients. Trial registration The IVOIRE cohort is registered with ClinicalTrials.gov under the identifier NCT01907581, registration date 17/7/2013.
BACKGROUND: The influence of socioeconomic status on patient outcomes is unclear. We assessed the impact of socioeconomic deprivation on severity of illness at intensive care unit (ICU) admission, and on the risk of death at 3 months after ICU admission. METHODS: The IVOIRE study was a prospective, observational, multicentre cohort study in the ICU of 8 participating hospitals in France, including patients aged ≥ 18 years admitted to the ICU and receiving at least one life support therapy for organ failure. The primary outcomes were severity at admission (assessed by SAPSII score), and mortality at 3 months. Socioeconomic data were obtained from interviews with patients or family. Deprivation was assessed using the EPICES score. RESULTS: Among 1294 patents included between 2013 and 2016, 629 (48.6%) were classed as deprived and differed significantly from non-deprived subjects in terms of sociodemographic characteristics and pre-existing conditions. The mean SAPS II score at admission was 50.1 ± 19.4 in deprived patients and 52.3 ± 17.3 in non-deprived patients, with no significant difference by multivariable analysis (β = - 1.85 [95% CI - 3.86; + 0.16, p = 0.072]). The proportion of death was 31.1% at 3 months, without significant differences between deprived and non-deprived patients, even after adjustment for confounders. CONCLUSIONS: Deprivation is frequent in patients admitted to the ICU and is not associated with disease severity at admission, or with mortality at 3 months between deprived and non-deprived patients. Trial registration The IVOIRE cohort is registered with ClinicalTrials.gov under the identifier NCT01907581, registration date 17/7/2013.
Entities:
Keywords:
Critically ill; Deprivation; Intensive care unit; Socioeconomic
Authors: Auguste Dargent; Jean-Paul Pais de Barros; Samir Saheb; Randa Bittar; Wilfried Le Goff; Alain Carrié; Thomas Gautier; Isabelle Fournel; Anne Laure Rerole; Hélène Choubley; David Masson; Laurent Lagrost; Jean-Pierre Quenot Journal: J Lipid Res Date: 2020-10-09 Impact factor: 5.922