Use of life support in acutely admitted ICU patients: An international cohort study
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Use of life support in acutely admitted ICU patients : An international cohort study. / Meyhoff, T S; Krag, M; Hjortrup, P B; Perner, A; Møller, M H; SUP-ICU inception cohort study investigators.
In: Acta Anaesthesiologica Scandinavica, Vol. 61, No. 5, 05.2017, p. 513-522.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Use of life support in acutely admitted ICU patients
T2 - An international cohort study
AU - Meyhoff, T S
AU - Krag, M
AU - Hjortrup, P B
AU - Perner, A
AU - Møller, M H
AU - SUP-ICU inception cohort study investigators
N1 - © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
PY - 2017/5
Y1 - 2017/5
N2 - BACKGROUND: Use of life support in intensive care unit (ICU) patients has been associated with increased risk of poor outcome. The prognostic importance of the duration of support is less studied. We assessed the use of life support and the association between its duration and 90-day mortality in a contemporary cohort of acutely admitted adult ICU patients.METHODS: We performed a post-hoc analysis of the SUP-ICU 7-day inception cohort study (n = 1034), which was conducted in 97 ICUs in 11 countries. We included patients with an ICU stay of 3 days or more. We assessed the use of life support during the first 3 days in ICU and the crude and adjusted association between its duration and 90-day mortality using logistic regression analyses.RESULTS: We included 690 patients; their 90-day mortality was 23%. During the first 3 days in ICU mechanical ventilation was used in 65%, vasopressors/inotropes in 57% and renal replacement therapy in 13%. Renal replacement therapy for 3 days or more was associated with a higher 90-day mortality as compared with 1 day of renal replacement therapy [odds ratio 6.5 (95% confidence interval 1.3 to 32.8)]. For mechanical ventilation and vasopressors/inotropes the odds ratios were 2.2 [0.9 to 5.3] and 1.2 [0.5 to 2.6], respectively.CONCLUSIONS: Among acutely admitted adult ICU patients, a higher number of days of renal replacement therapy in the initial ICU stay were associated with increased risk of death within 90 days. We did not observe such an association for mechanical ventilation or vasopressor/inotropic therapy.
AB - BACKGROUND: Use of life support in intensive care unit (ICU) patients has been associated with increased risk of poor outcome. The prognostic importance of the duration of support is less studied. We assessed the use of life support and the association between its duration and 90-day mortality in a contemporary cohort of acutely admitted adult ICU patients.METHODS: We performed a post-hoc analysis of the SUP-ICU 7-day inception cohort study (n = 1034), which was conducted in 97 ICUs in 11 countries. We included patients with an ICU stay of 3 days or more. We assessed the use of life support during the first 3 days in ICU and the crude and adjusted association between its duration and 90-day mortality using logistic regression analyses.RESULTS: We included 690 patients; their 90-day mortality was 23%. During the first 3 days in ICU mechanical ventilation was used in 65%, vasopressors/inotropes in 57% and renal replacement therapy in 13%. Renal replacement therapy for 3 days or more was associated with a higher 90-day mortality as compared with 1 day of renal replacement therapy [odds ratio 6.5 (95% confidence interval 1.3 to 32.8)]. For mechanical ventilation and vasopressors/inotropes the odds ratios were 2.2 [0.9 to 5.3] and 1.2 [0.5 to 2.6], respectively.CONCLUSIONS: Among acutely admitted adult ICU patients, a higher number of days of renal replacement therapy in the initial ICU stay were associated with increased risk of death within 90 days. We did not observe such an association for mechanical ventilation or vasopressor/inotropic therapy.
KW - Acute Disease
KW - Aged
KW - Australasia
KW - Canada
KW - Cohort Studies
KW - Critical Care
KW - Europe
KW - Female
KW - Humans
KW - Intensive Care Units
KW - Length of Stay
KW - Life Support Care
KW - Male
KW - Middle Aged
KW - Renal Replacement Therapy
KW - Respiration, Artificial
KW - Time Factors
KW - Vasoconstrictor Agents
KW - Journal Article
U2 - 10.1111/aas.12878
DO - 10.1111/aas.12878
M3 - Journal article
C2 - 28295151
VL - 61
SP - 513
EP - 522
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 5
ER -
ID: 185721419