Factors Affecting the Length of Stay in the Intensive Care Unit: Our Clinical Experience

Toptaş, Mehmet; Samancı, Nilay Şengül; Akkoç, İbrahim; Yücetaş, Esma; Cebeci, Egemen; Şen, Öznur; Can, Mehmet Mustafa; Öztürk, Savaş

doi:10.1155/2018/9438046

Cited by 31 publications

(19 citation statements)

References 12 publications

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“…A study of patients admitted to ICU in Turkey showed that patients with cardiovascular system diseases, multiple diseases, nervous system diseases, and cerebrovascular diseases had a prolonged stay in the ICU. 14 A study conducted on the characteristics of the elderly admitted in medical ICU in Morocco, the mean ICU length of stay was 6.6 ± 6 days for all admissions, and the figures for survivors and nonsurvivors were similar. The mean age of the patients in this study was 70 years as in our study, and it considered only medical ICU patients and 64% of deaths occurred during the first five days after admission in ICU 6 .…”

Section: Discussionmentioning

confidence: 97%

Factors Associated with the Outcome of Older Patients Admitted in Geriatric Intensive Care Unit

Thangam¹,

Deepa²

2019

Journal of the Indian Academy of Geriatrics

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Objective: To determine the factors associated with the outcome of older patients admitted in Geriatric Intensive Care Unit. Materials and Methods: This cross-sectional, observational study was conducted in the Geriatric Intensive Care Unit of the Department of Geriatric Medicine, Madras Medical College, Chennai. one hundred and seventy two patients, aged 60 and above, admitted in the Geriatric ICU during the period of 6 months, from January 2017 to June 2017, were selected to participate in this study. Data regarding age, sex, number of comorbidities, major organ system involved, duration of stay and procedures underwent in the ICU were collected and analyzed. Results: Out of the 172 samples, 92 were males, and 80 were females. The mean age of the study population was 70.1 ± 8.3 years. We found no association between age and survival (p=0.581), gender and survival (p=0.298). 30.2% of the samples who expired had four comorbidities. We found a statistically significant association between the number of comorbidities and outcome (p<0.008). Around 44 patients (25.6%) had respiratory problems, and it was the commonest cause of admission to ICU in this study. We found no association between major system involved and outcome (p=0.089). Sixty of the study participants (34.9%) needed mechanical ventilatory support. We found a statistical significance between procedure underwent and outcome (p<0.001). 57.5% of the study participants stayed in the GICU up to 1 week. We found a statistical significance between the duration of stay and outcome (p=0.022). In this study, 71.5% of the study participants survived, 3.5% of them went against medical advice, and 25% of them expired. Conclusion: In this study, the outcome of older patients admitted in Geriatric Intensive Care Unit depended on the number of preexisting comorbidities, length of stay and procedure underwent during the ICU stay but not the chronological age. In this study, only one in four died after undergoing treatment in the Geriatric Intensive care unit. Geriatric intensive care services can improve the outcome of older patients admitted with a critical illness.

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Section: Discussionmentioning

confidence: 97%

Factors Associated with the Outcome of Older Patients Admitted in Geriatric Intensive Care Unit

Thangam¹,

Deepa²

2019

Journal of the Indian Academy of Geriatrics

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“…Toptas et al showed that length of stay of in the ICU is significantly longer for non-surgical patients than for surgical patients (P < 0.01). 24 Therefore, it is difficult to compare the length of stay of the present study cohort with other studies dealing with geriatric ICU patients. Most of them include predominantly medical patients, mainly without restrictions regarding the reason for admission.…”

Section: Discussionmentioning

confidence: 93%

Type of underlying fracture after the surgical treatment of geriatric trauma patients has no effect on mortality during intensive care treatment

Knauf

Jensen

Hack

et al. 2020

Geriatrics Gerontology Int

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Aim Due to demographic change, the number of geriatric patients is still rising. Although hip fractures are the subject of current research, little is known about the remaining geriatric trauma entities. The aim of this study was to collect data of the age‐related traumatological intensive care unit (ICU) population, its underlying diagnosis, and the influence on mortality and length of stay in the ICU. Methods Geriatric trauma patients (aged ≥65 years) treated postoperatively in our surgical ICU were included in this retrospective observational study covering the period 2013–2017. In addition to the underlying fracture entities, patient characteristics, such as age, sex, Charlson Comorbidity Index, length of stay and mortality, were collected to identify possible independent predictive factors for mortality in the ICU using multivariate analysis. Results During the observation period, 805 (60.5%) patients met the inclusion criteria. 47.6% of the patients suffered from a proximal femoral fracture. The total mortality rate during the stay in the ICU was 7.5%. Significant predictive factors for mortality in the ICU were Charlson Comorbidity Index (P < 0.001) and length of stay (P < 0.001). The different fracture types themselves were not a significant risk factor for mortality (P = 0.862). Conclusion Patients with proximal femoral fractures account for approximately half of the patients in intensive care. The mortality rate of these patients is no higher than that in geriatric trauma patients with other fractures. The progression is essentially influenced by the patient's comorbidities. Nowadays, the focus shifts from trauma care to the therapy of concomitant diseases. Nevertheless, this cohort, when adequately treated, shows a comparatively low mortality rate. Geriatr Gerontol Int 2020; 20: 1120–1125.

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“…However, the accuracy of ICU LOS predictions made by clinicians has been poorly evaluated. Studies reported that variables, such as post-operative monitoring, systolic arterial pressure, creatinine level, invasive mechanical ventilation, and active infection et al, were associated with ICU LOS [47][48][49][50]. In the ICU time-length study, Huang performed two types of analyses, in which a singlefactor correlation analysis found a large number of changes in the blood cell indexes of hospitalized patients in relation to their in-hospital mortality, both mentioning the ratio of monocytes to basophils; in the multifactorial regression, basophils, leukocytes, MCHC were independent factors associated with in-hospital mortality [51].…”

Section: Discussionmentioning

confidence: 99%

Risk factors and socio-economic burden in pancreatic ductal adenocarcinoma operation: a machine learning based analysis

et al. 2020

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Background Surgical resection is the major way to cure pancreatic ductal adenocarcinoma (PDAC). However, this operation is complex, and the peri-operative risk is high, making patients more likely to be admitted to the intensive care unit (ICU). Therefore, establishing a risk model that predicts admission to ICU is meaningful in preventing patients from post-operation deterioration and potentially reducing socio-economic burden. Methods We retrospectively collected 120 clinical features from 1242 PDAC patients, including demographic data, pre-operative and intra-operative blood tests, in-hospital duration, and ICU status. Machine learning pipelines, including Supporting Vector Machine (SVM), Logistic Regression, and Lasso Regression, were employed to choose an optimal model in predicting ICU admission. Ordinary least-squares regression (OLS) and Lasso Regression were adopted in the correlation analysis of post-operative bleeding, total in-hospital duration, and discharge costs. Results SVM model achieved higher performance than the other two models, resulted in an AU-ROC of 0.80. The features, such as age, duration of operation, monocyte count, and intra-operative partial arterial pressure of oxygen (PaO2), are risk factors in the ICU admission. The protective factors include RBC count, analgesic pump dexmedetomidine (DEX), and intra-operative maintenance of DEX. Basophil percentage, duration of the operation, and total infusion volume were risk variables for staying in ICU. The bilirubin, CA125, and pre-operative albumin were associated with the post-operative bleeding volume. The operation duration was the most important factor for discharge costs, while pre-lymphocyte percentage and the absolute count are responsible for less cost. Conclusions We observed that several new indicators such as DEX, monocyte count, basophil percentage, and intra-operative PaO2 showed a good predictive effect on the possibility of admission to ICU and duration of stay in ICU. This work provided an essential reference for indication in advance to PDAC operation.

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Factors Affecting the Length of Stay in the Intensive Care Unit: Our Clinical Experience

Cited by 31 publications

References 12 publications

Factors Associated with the Outcome of Older Patients Admitted in Geriatric Intensive Care Unit

Factors Associated with the Outcome of Older Patients Admitted in Geriatric Intensive Care Unit

Type of underlying fracture after the surgical treatment of geriatric trauma patients has no effect on mortality during intensive care treatment

Risk factors and socio-economic burden in pancreatic ductal adenocarcinoma operation: a machine learning based analysis

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