Who Dies after ICU Discharge? Retrospective Analysis of Prognostic Factors for In-Hospital Mortality of ICU Survivors.
10.3346/jkms.2017.32.3.528
- Author:
Jungsil LEE
1
;
Young Jae CHO
;
Se Joong KIM
;
Ho Il YOON
;
Jong Sun PARK
;
Choon Taek LEE
;
Jae Ho LEE
;
Yeon Joo LEE
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. yeonjoolee1117@gmail.com
- Publication Type:Original Article
- Keywords:
Hospital Mortality;
Intensive Care Unit;
Risk Factors
- MeSH:
Cause of Death;
Cohort Studies;
Comorbidity;
Hematologic Diseases;
Hospital Mortality*;
Humans;
Inpatients;
Intensive Care Units;
Korea;
Length of Stay;
Multivariate Analysis;
Platelet Count;
Respiratory Insufficiency;
Retrospective Studies*;
Risk Factors;
Seoul;
Sepsis;
Survivors*
- From:Journal of Korean Medical Science
2017;32(3):528-533
- CountryRepublic of Korea
- Language:English
-
Abstract:
We investigated the causes of inpatient death after intensive care unit (ICU) discharge and determined predictors of in-hospital mortality in Korea. Using medical ICU registry data of Seoul National University Hospital, we performed a retrospective cohort study involving patients who were discharged alive from their first ICU admission with at least 24 hours of ICU length of stay (LOS). From January 2011 to August 2013, 723 patients were admitted to ICU and 383 patients were included. The estimated in-hospital mortality rate was 11.7% (45/383). The most common cause of death was respiratory failure (n = 25, 56%) followed by sepsis and cancer progression; the causes of hospital death and ICU admission were the same in 64% of all deaths; sudden unexpected deaths comprised about one-fifth of all deaths. In order to predict in-hospital mortality among ICU survivors, multivariate analysis identified presence of solid tumor (odds ratio [OR], 4.06; 95% confidence interval [CI], 2.01–8.2; P < 0.001), hematologic disease (OR, 4.75; 95% CI, 1.51–14.96; P = 0.013), Sequential Organ Failure Assessment (SOFA) score upon ICU admission (OR, 1.08; 95% CI, 0.99–1.17; P = 0.075), and hemoglobin (Hb) level (OR, 0.67; 95% CI, 0.52–0.86; P = 0.001) and platelet count (Plt) (OR, 0.99; 95% CI, 0.99–1.00; P = 0.033) upon ICU discharge as significant factors. In conclusion, a significant proportion of in-hospital mortality is predictable and those who die in hospital after ICU discharge tend to be severely-ill, with comorbidities of hematologic disease and solid tumor, and anemic and thrombocytopenic upon ICU discharge.
