Mortality After Hospital Discharge in ICU Patients*

Brinkman, Sylvia; Jonge, Evert de; Abu‐Hanna, Ameen; Arbous, M. Sesmu; Lange, Dylan W. de; Keizer, Nicolette F. de

doi:10.1097/ccm.0b013e31827ca4e1

Cited by 94 publications

(92 citation statements)

References 23 publications

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“…Previous comparisons between ICU patients in general and sepsis patients in particular have shown a higher post-ICU mortality risk than in the general public (79)(80)(81)96), and a higher risk of death post-ICU in sepsis patients in than in other patient categories (83,98,100). However, it is unclear to what extent this increased risk of death is related to sepsis itself, or to the severity of illness during the acute phase, irrespective of the underlying cause.…”

Section: On Predicting Cardiac Outcome In Icu Patients (Papers I -Iv)mentioning

confidence: 99%

“…However, as many as one-third of ICU patients may still be in hospital at 30 days, and a substantial proportion of deaths occur soon after hospital discharge (83,84). There are also indications of an increasing number of ICU patients being discharged from hospital not to home, but to other care facilities (5).…”

Section: Icu Outcome and Follow-upmentioning

confidence: 99%

“…The most appropriate follow-up time as well as the best starting point for follow-up in studies on long-term mortality after ICU is a subject of ongoing debate (82,83). Mortality after ICU discharge has been described to reach a plateau after 90 days (85) and few studies have followed patients beyond six months (84,122).…”

Section: Follow-up Timementioning

confidence: 99%

“…Mortality after ICU discharge has been described to reach a plateau after 90 days (85) and few studies have followed patients beyond six months (84,122). Others have demonstrated an increased rate of death for at least two to three years (79,83,96) In study IV, data was collected from medical registers, and the accuracy of diagnoses and other data collected and used for analysis was not monitored. Furthermore, the diagnoses recorded as causes of death are largely reported on a clinical basis.…”

Section: Follow-up Timementioning

confidence: 99%

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Cardiac dysfunction in septic shock : Observational studies on characteristics and outcome

Geer

2016

Linköping University Medical Dissertations

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Background: Cardiac dysfunction is a well-known complication of sepsis, but its characteristics and consequences, especially on a longer term, remain unclear. The aim of this thesis was to study the characteristics and the implications of cardiac dysfunction for outcome in intensive care unit (ICU) patients with septic shock. Purpose: First, to assess the ability of a cardiac biomarker to predict outcome in ICU patients. Second, to characterise cardiac dysfunction in septic shock using speckle tracking echocardiography. Third, to investigate the reliability of echocardiographic methods used to describe cardiac dysfunction in septic shock. Fourth, to study long-term cardiac outcome in severe sepsis and septic shock patients. Materials and methods: The cardiac biomarker amino-terminal pro-brain natriuretic peptide (NTproBNP) was collected in 481 patients on ICU admission and its ability to predict death was assessed. In 50 patients with septic shock, echocardiography was performed on ICU admission and was repeated during and after ICU stay. Measurements of cardiac strain using speckle tracking echocardiography were assessed in relation to other echocardiographic function parameters, NT-proBNP and severity of illness scores, and their change over time was analysed. Echocardiograms from patients with septic shock were independently evaluated by two physicians and the results analysed regarding measurement variability. A nationwide-registry-based open cohort of 9,520 severe sepsis and septic shock ICU patients discharged alive from the ICU was analysed together with a non-septic control group matched for age, sex and severity of illness. In patients who died after ICU discharge, information on causes of death was collected. Results: A discriminatory level of significance of NT-proBNP on ICU admission was identified at ≥1,380 ng/L, above which NT-proBNP was an independent predictor of death. With increasing levels of NT-proBNP, patients were more severely ill, had a longer ICU stay and were more often admitted with septic shock. Cardiac strain was frequently impaired in septic shock patients but was not superior to other echocardiographic measurements in detecting cardiac dysfunction. Cardiac strain correlated with other echocardiographic function parameters and with NT-proBNP, and was the least user-dependent echocardiographic parameter in septic shock patients. Cardiac strain remained unchanged over time, did not differ between survivors and non-survivors and could not predict an increased risk of death. During a follow-up of up to nearly 6 years after ICU discharge, 3,954 (42%) of sepsis patients died, 654 (17%) with cardiac failure as the cause of death. With increasing severity of illness on admission, the risk of death with cardiac failure as the cause of death after ICU discharge increased. In comparison to other ICU patients with similar severity of illness, however, the risk of death due to cardiac was not increased in patients with severe sepsis or septic shock. Conclusions: Laboratory or echocardiographic si...

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Section: On Predicting Cardiac Outcome In Icu Patients (Papers I -Iv)mentioning

confidence: 99%

Section: Icu Outcome and Follow-upmentioning

confidence: 99%

Section: Follow-up Timementioning

confidence: 99%

Section: Follow-up Timementioning

confidence: 99%

See 2 more Smart Citations

Cardiac dysfunction in septic shock : Observational studies on characteristics and outcome

Geer

2016

Linköping University Medical Dissertations

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“…A large proportion of patients nursed in a general intensive care unit die within the first months after discharge, 52 and it has been shown that these patients have decreased survival compared with that of the general population. 53 Several factors indicate that there can be differences in longterm survival of patients after burns when compared with that of patients nursed in general intensive care. 54,55 Patients with burns are injured, not ill; they are younger than most of those in a general intensive care unit, and their pre-existing medical conditions differ.…”

Section: Long-term Survivalmentioning

confidence: 99%

Outcome of burn care : the mortality perspective

Pompermaier¹

2017

Linköping University Medical Dissertations

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Intensive care admission of cancer patients: a comparative analysis

et al. 2015

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The aim of this study was to obtain insight into which proportion of cancer patients is admitted to an Intensive Care Unit (ICU) and how their survival, demographic, and clinical characteristics relate to cancer patients not admitted to the ICU. Data from patients registered with cancer between 2006 and 2011 in four hospitals in the Netherlands were linked to the Dutch National Intensive Care Evaluation registry. About 36,860 patients with cancer were identified, of whom 2,374 (6.4%) were admitted to the ICU. Fifty-six percent of ICU admissions were after surgery, whereas 44% were for medical reasons. The risk for ICU admission was highest among cancer patients treated with surgery either alone or combined with chemotherapy and/or radiation therapy. Only 80 of 1,073 medical ICU admissions (3.3%) were for cancer-specific reasons. Although more women (54.0%) than men were registered with cancer, the proportion of male cancer patients admitted to an ICU was much higher (9.3 vs. 4.0%, P < 0.001). Five-year survival of cancer patients admitted to the ICU was substantial (41%) although median survival was much lower (1,104 days) than in patients not admitted to the ICU (median survival time not reached, P < 0.001). These results show that one out of 16 cancer patients was admitted to an ICU and that ICU support for this group should not be considered futile.

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Mortality After Hospital Discharge in ICU Patients*

Cited by 94 publications

References 23 publications

Cardiac dysfunction in septic shock : Observational studies on characteristics and outcome

Cardiac dysfunction in septic shock : Observational studies on characteristics and outcome

Outcome of burn care : the mortality perspective

Intensive care admission of cancer patients: a comparative analysis

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