Comorbidities Pre-ICU Admission, Strong Predictors of Hospital Resource Use
HealthDay News — Intensive care unit (ICU) patients surviving to hospital discharge have higher 5 year mortality and hospital resource use than hospital controls, according to a study published online January 27 in the American Journal of Respiratory and Critical Care Medicine.
Nazir I. Lone, PhD, from the University of Edinburgh in the United Kingdom, and colleagues examined factors associated with increased hospital resource use among patients admitted to adult general ICUs. Data were included for 5,259 ICU patents admitted during 2005 who survived to hospital discharge and 5,215 matched hospital controls.
The researchers found that factors present before ICU admission (comorbidities) were stronger predictors of hospital resource use than acute illness factors. Compared with hospital controls, the ICU cohort had higher mortality (32.3 versus 22.7%; hazard ratio, 1.33), used more hospital resources (mean hospital admission rate, 4.8 versus 3.3/person/five years), and had higher mean five-year hospital costs ($25,608 versus $16,913/patient) in the five years after the initial hospital discharge. After adjustment for confounders and using pre-post analyses, increased resource use persisted (both P < 0.001). Younger patients without significant comorbidity had the greatest excess resource use and mortality.
"ICU survivorship is associated with higher five-year mortality and hospital resource utilization than hospital controls, representing a substantial burden on individuals, caregivers, and society," the authors write.