Prediction of chronic critical illness in a general intensive care unit

Sérgio H. Loss , Cláudia B. Marchese , Márcio M. Boniatti , Iuri C. Wawrzeniak , Roselaine P. Oliveira , Luciana N. Nunes , Josué A. Victorino
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Abstract

Objective

To assess the incidence, costs, and mortality associated with chronic critical illness (CCI), and to identify clinical predictors of CCI in a general intensive care unit.

Methods

This was a prospective observational cohort study. All patients receiving supportive treatment for over 20 days were considered chronically critically ill and eligible for the study. After applying the exclusion criteria, 453 patients were analyzed.

Results

There was an 11% incidence of CCI. Total length of hospital stay, costs, and mortality were significantly higher among patients with CCI. Mechanical ventilation, sepsis, Glasgow score < 15, inadequate calorie intake, and higher body mass index were independent predictors for CCI in the multivariate logistic regression model.

Conclusions

CCI affects a distinctive population in intensive care units with higher mortality, costs, and prolonged hospitalization. Factors identifiable at the time of admission or during the first week in the intensive care unit can be used to predict CCI.

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普通重症监护病房慢性危重疾病的预测
目的评估慢性危重症(CCI)的发病率、成本和死亡率,并确定普通重症监护病房CCI的临床预测因素。方法前瞻性观察队列研究。所有接受支持治疗超过20天的患者都被认为是慢性危重症患者,符合研究条件。应用排除标准对453例患者进行分析。结果CCI发生率为11%。CCI患者的总住院时间、费用和死亡率显著高于CCI患者。机械通气,败血症,格拉斯哥评分<15、在多变量logistic回归模型中,热量摄入不足和较高的体重指数是CCI的独立预测因子。结论scci影响重症监护病房的特殊人群,具有较高的死亡率、费用和住院时间。入院时或重症监护病房第一周可识别的因素可用于预测CCI。
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