Effect of length of stay in intensive care unit on hospital and long-term mortality of critically ill adult patients

Williams, T. A., Ho, K. M., Dobb, G. J., Finn, J. C., Knuiman, M., Webb, S. A .R. and Royal Perth Hospital ICU Data Linkage Group (2010) Effect of length of stay in intensive care unit on hospital and long-term mortality of critically ill adult patients. British Journal of Anaesthesia, 104 4: 459-464. doi:10.1093/bja/aeq025


Author Williams, T. A.
Ho, K. M.
Dobb, G. J.
Finn, J. C.
Knuiman, M.
Webb, S. A .R.
Royal Perth Hospital ICU Data Linkage Group
Title Effect of length of stay in intensive care unit on hospital and long-term mortality of critically ill adult patients
Journal name British Journal of Anaesthesia   Check publisher's open access policy
ISSN 0007-0912
1471-6771
Publication date 2010-04
Sub-type Article (original research)
DOI 10.1093/bja/aeq025
Open Access Status
Volume 104
Issue 4
Start page 459
End page 464
Total pages 6
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Background: Critical illness leading to prolonged length of stay (LOS) in an intensive care unit (ICU) is associated with significant mortality and resource utilization. This study assessed the independent effect of ICU LOS on in-hospital and long-term mortality after hospital discharge.

Methods: Clinical and mortality data of 22 298 patients, aged 16 yr and older, admitted to ICU between 1987 and 2002 were included in this linked-data cohort study. Cox's regression with restricted cubic spline function was used to model the effect of LOS on in-hospital and long-term mortality after adjusting for age, gender, acute physiology score (APS), maximum number of organ failures, era of admission, elective admission, Charlson's co-morbidity index, and diagnosis. The variability each predictor explained was calculated by the percentage of the χ2 statistic contribution to the total χ2 statistic.

Results: Most hospital deaths occurred within the first few days of ICU admission. Increasing LOS in ICU was not associated with an increased risk of in-hospital mortality after adjusting for other covariates, but was associated with an increased risk of long-term mortality after hospital discharge. The variability on the long-term mortality effect associated with ICU LOS (2.3%) appeared to reach a plateau after the first 10 days in ICU and was not as important as age (35.8%), co-morbidities (18.6%), diagnosis (10.9%), and APS (3.6%).

Conclusions: LOS in ICU was not an independent risk factor for in-hospital mortality, but it had a small effect on long-term mortality after hospital discharge after adjustment for other risk factors. 
Keyword Costs
Length of stay
Mortality
Survival
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
 
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Created: Fri, 18 Jul 2014, 10:22:39 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work