Predictors of death and new disability after critical illness: a multicentre prospective cohort study
Purpose This study aimed to determine the prevalence and predictors of death or new disability following critical illness. Methods Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h...
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| Veröffentlicht in: | Intensive care medicine 2021-07, Vol.47 (7), p.772-781 |
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| creator | Higgins, A. M. Neto, A. Serpa Bailey, M. Barrett, J. Bellomo, R. Cooper, D. J. Gabbe, B. J. Linke, N. Myles, P. S. Paton, M. Philpot, S. Shulman, M. Young, M. Hodgson, C. L. |
| description | Purpose
This study aimed to determine the prevalence and predictors of death or new disability following critical illness.
Methods
Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h of mechanical ventilation. The primary outcome was death or new disability at 6 months, with new disability defined by a 10% increase in the WHODAS 2.0.
Results
Of 628 patients with the primary outcome available (median age of 62 [49–71] years, 379 [61.0%] had a medical admission and 370 (58.9%) died or developed new disability by 6 months. Independent predictors of death or new disability included age [OR 1.02 (1.01–1.03),
P
= 0.001], higher severity of illness (APACHE III) [OR 1.02 (1.01–1.03),
P
|
| doi_str_mv | 10.1007/s00134-021-06438-7 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2537644932</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A723899987</galeid><sourcerecordid>A723899987</sourcerecordid><originalsourceid>FETCH-LOGICAL-c457t-340de767c09076c355c83fb0021df660a7424cee0970c85f2fda589bcc4470c93</originalsourceid><addsrcrecordid>eNp9ks1rXCEUxaW00GmafyAroZtuTHx-PN_rLoR-BALtolmLo9eJwdGp-lrmv6-TKYSWobgQDr9zufdwELoY6OVAqbqqlA5cEMoGQkfBJ6JeoNUgOCMD49NLtKJcMCJGwV6jN7U-dlyNclgh-FbABdtyqTh77MC0B2ySwwl-YReqWYcY2h4b36BgW0IL1kQcYkxQ6wds8HaJXYPUCuBdyXUHtoWfgG1-yKXh2ha3f4teeRMrnP_5z9D9p4_fb76Qu6-fb2-u74gVUjXCBXWgRmXpTNVouZR24n5N-1nOjyM1SjBhAeisqJ2kZ94ZOc1ra4XoyszP0Pvj3L7IjwVq09tQLcRoEuSlaia5GoWYOevou3_Qx7yU1LfrlJiEpFLxZ2pjIuiQfG7F2MNQfa16svM8T6pT5AS1gQTFxJzAhy7_xV-e4PtzsA32pIEdDbYHXAt4vStha8peD1QfCqCPBdA9Kf1UAH0w8aOpdjhtoDxf-B_Xb5JMsa8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2548450573</pqid></control><display><type>article</type><title>Predictors of death and new disability after critical illness: a multicentre prospective cohort study</title><source>SpringerLink Journals - AutoHoldings</source><creator>Higgins, A. M. ; Neto, A. Serpa ; Bailey, M. ; Barrett, J. ; Bellomo, R. ; Cooper, D. J. ; Gabbe, B. J. ; Linke, N. ; Myles, P. S. ; Paton, M. ; Philpot, S. ; Shulman, M. ; Young, M. ; Hodgson, C. L.</creator><creatorcontrib>Higgins, A. M. ; Neto, A. Serpa ; Bailey, M. ; Barrett, J. ; Bellomo, R. ; Cooper, D. J. ; Gabbe, B. J. ; Linke, N. ; Myles, P. S. ; Paton, M. ; Philpot, S. ; Shulman, M. ; Young, M. ; Hodgson, C. L. ; on behalf of the PREDICT Study Investigators</creatorcontrib><description>Purpose
This study aimed to determine the prevalence and predictors of death or new disability following critical illness.
Methods
Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h of mechanical ventilation. The primary outcome was death or new disability at 6 months, with new disability defined by a 10% increase in the WHODAS 2.0.
Results
Of 628 patients with the primary outcome available (median age of 62 [49–71] years, 379 [61.0%] had a medical admission and 370 (58.9%) died or developed new disability by 6 months. Independent predictors of death or new disability included age [OR 1.02 (1.01–1.03),
P
= 0.001], higher severity of illness (APACHE III) [OR 1.02 (1.01–1.03),
P
< 0.001] and admission diagnosis. Compared to patients with a surgical admission diagnosis, patients with a cardiac arrest [OR (95% CI) 4.06 (1.89–8.68),
P
< 0.001], sepsis [OR (95% CI) 2.43 (1.32–4.47),
P
= 0.004], or trauma [OR (95% CI) 6.24 (3.07–12.71),
P
< 0.001] diagnosis had higher odds of death or new disability, while patients with a lung transplant [OR (95% CI) 0.21 (0.07–0.58),
P
= 0.003] diagnosis had lower odds. A model including these three variables had good calibration (Brier score 0.20) and acceptable discriminative power with an area under the receiver operating characteristic curve of 0.76 (95% CI 0.72–0.80).
Conclusion
Less than half of all patients mechanically ventilated for more than 24 h were alive and free of new disability at 6 months after admission to ICU. A model including age, illness severity and admission diagnosis has acceptable discriminative ability to predict death or new disability at 6 months.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-021-06438-7</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Analysis ; Anesthesiology ; Cardiac patients ; Clinical outcomes ; Cohort analysis ; Critical care ; Critical Care Medicine ; Death ; Diagnosis ; Disability ; Emergency Medicine ; Health risks ; Illnesses ; Intensive ; Intensive care units ; Life expectancy ; Lung transplantation ; Mechanical ventilation ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Mortality ; NCT ; NCT03226912 ; Original ; Pain Medicine ; Pediatrics ; Pneumology/Respiratory System ; Recovery (Medical) ; Sepsis ; Trauma ; Ventilation</subject><ispartof>Intensive care medicine, 2021-07, Vol.47 (7), p.772-781</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-340de767c09076c355c83fb0021df660a7424cee0970c85f2fda589bcc4470c93</citedby><cites>FETCH-LOGICAL-c457t-340de767c09076c355c83fb0021df660a7424cee0970c85f2fda589bcc4470c93</cites><orcidid>0000-0001-9002-2075</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00134-021-06438-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00134-021-06438-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Higgins, A. M.</creatorcontrib><creatorcontrib>Neto, A. Serpa</creatorcontrib><creatorcontrib>Bailey, M.</creatorcontrib><creatorcontrib>Barrett, J.</creatorcontrib><creatorcontrib>Bellomo, R.</creatorcontrib><creatorcontrib>Cooper, D. J.</creatorcontrib><creatorcontrib>Gabbe, B. J.</creatorcontrib><creatorcontrib>Linke, N.</creatorcontrib><creatorcontrib>Myles, P. S.</creatorcontrib><creatorcontrib>Paton, M.</creatorcontrib><creatorcontrib>Philpot, S.</creatorcontrib><creatorcontrib>Shulman, M.</creatorcontrib><creatorcontrib>Young, M.</creatorcontrib><creatorcontrib>Hodgson, C. L.</creatorcontrib><creatorcontrib>on behalf of the PREDICT Study Investigators</creatorcontrib><title>Predictors of death and new disability after critical illness: a multicentre prospective cohort study</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>Purpose
This study aimed to determine the prevalence and predictors of death or new disability following critical illness.
Methods
Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h of mechanical ventilation. The primary outcome was death or new disability at 6 months, with new disability defined by a 10% increase in the WHODAS 2.0.
Results
Of 628 patients with the primary outcome available (median age of 62 [49–71] years, 379 [61.0%] had a medical admission and 370 (58.9%) died or developed new disability by 6 months. Independent predictors of death or new disability included age [OR 1.02 (1.01–1.03),
P
= 0.001], higher severity of illness (APACHE III) [OR 1.02 (1.01–1.03),
P
< 0.001] and admission diagnosis. Compared to patients with a surgical admission diagnosis, patients with a cardiac arrest [OR (95% CI) 4.06 (1.89–8.68),
P
< 0.001], sepsis [OR (95% CI) 2.43 (1.32–4.47),
P
= 0.004], or trauma [OR (95% CI) 6.24 (3.07–12.71),
P
< 0.001] diagnosis had higher odds of death or new disability, while patients with a lung transplant [OR (95% CI) 0.21 (0.07–0.58),
P
= 0.003] diagnosis had lower odds. A model including these three variables had good calibration (Brier score 0.20) and acceptable discriminative power with an area under the receiver operating characteristic curve of 0.76 (95% CI 0.72–0.80).
Conclusion
Less than half of all patients mechanically ventilated for more than 24 h were alive and free of new disability at 6 months after admission to ICU. A model including age, illness severity and admission diagnosis has acceptable discriminative ability to predict death or new disability at 6 months.</description><subject>Age</subject><subject>Analysis</subject><subject>Anesthesiology</subject><subject>Cardiac patients</subject><subject>Clinical outcomes</subject><subject>Cohort analysis</subject><subject>Critical care</subject><subject>Critical Care Medicine</subject><subject>Death</subject><subject>Diagnosis</subject><subject>Disability</subject><subject>Emergency Medicine</subject><subject>Health risks</subject><subject>Illnesses</subject><subject>Intensive</subject><subject>Intensive care units</subject><subject>Life expectancy</subject><subject>Lung transplantation</subject><subject>Mechanical ventilation</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Mortality</subject><subject>NCT</subject><subject>NCT03226912</subject><subject>Original</subject><subject>Pain Medicine</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Recovery (Medical)</subject><subject>Sepsis</subject><subject>Trauma</subject><subject>Ventilation</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9ks1rXCEUxaW00GmafyAroZtuTHx-PN_rLoR-BALtolmLo9eJwdGp-lrmv6-TKYSWobgQDr9zufdwELoY6OVAqbqqlA5cEMoGQkfBJ6JeoNUgOCMD49NLtKJcMCJGwV6jN7U-dlyNclgh-FbABdtyqTh77MC0B2ySwwl-YReqWYcY2h4b36BgW0IL1kQcYkxQ6wds8HaJXYPUCuBdyXUHtoWfgG1-yKXh2ha3f4teeRMrnP_5z9D9p4_fb76Qu6-fb2-u74gVUjXCBXWgRmXpTNVouZR24n5N-1nOjyM1SjBhAeisqJ2kZ94ZOc1ra4XoyszP0Pvj3L7IjwVq09tQLcRoEuSlaia5GoWYOevou3_Qx7yU1LfrlJiEpFLxZ2pjIuiQfG7F2MNQfa16svM8T6pT5AS1gQTFxJzAhy7_xV-e4PtzsA32pIEdDbYHXAt4vStha8peD1QfCqCPBdA9Kf1UAH0w8aOpdjhtoDxf-B_Xb5JMsa8</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Higgins, A. M.</creator><creator>Neto, A. Serpa</creator><creator>Bailey, M.</creator><creator>Barrett, J.</creator><creator>Bellomo, R.</creator><creator>Cooper, D. J.</creator><creator>Gabbe, B. J.</creator><creator>Linke, N.</creator><creator>Myles, P. S.</creator><creator>Paton, M.</creator><creator>Philpot, S.</creator><creator>Shulman, M.</creator><creator>Young, M.</creator><creator>Hodgson, C. L.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9002-2075</orcidid></search><sort><creationdate>20210701</creationdate><title>Predictors of death and new disability after critical illness: a multicentre prospective cohort study</title><author>Higgins, A. M. ; Neto, A. Serpa ; Bailey, M. ; Barrett, J. ; Bellomo, R. ; Cooper, D. J. ; Gabbe, B. J. ; Linke, N. ; Myles, P. S. ; Paton, M. ; Philpot, S. ; Shulman, M. ; Young, M. ; Hodgson, C. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c457t-340de767c09076c355c83fb0021df660a7424cee0970c85f2fda589bcc4470c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Analysis</topic><topic>Anesthesiology</topic><topic>Cardiac patients</topic><topic>Clinical outcomes</topic><topic>Cohort analysis</topic><topic>Critical care</topic><topic>Critical Care Medicine</topic><topic>Death</topic><topic>Diagnosis</topic><topic>Disability</topic><topic>Emergency Medicine</topic><topic>Health risks</topic><topic>Illnesses</topic><topic>Intensive</topic><topic>Intensive care units</topic><topic>Life expectancy</topic><topic>Lung transplantation</topic><topic>Mechanical ventilation</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Mortality</topic><topic>NCT</topic><topic>NCT03226912</topic><topic>Original</topic><topic>Pain Medicine</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Recovery (Medical)</topic><topic>Sepsis</topic><topic>Trauma</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Higgins, A. M.</creatorcontrib><creatorcontrib>Neto, A. Serpa</creatorcontrib><creatorcontrib>Bailey, M.</creatorcontrib><creatorcontrib>Barrett, J.</creatorcontrib><creatorcontrib>Bellomo, R.</creatorcontrib><creatorcontrib>Cooper, D. J.</creatorcontrib><creatorcontrib>Gabbe, B. J.</creatorcontrib><creatorcontrib>Linke, N.</creatorcontrib><creatorcontrib>Myles, P. S.</creatorcontrib><creatorcontrib>Paton, M.</creatorcontrib><creatorcontrib>Philpot, S.</creatorcontrib><creatorcontrib>Shulman, M.</creatorcontrib><creatorcontrib>Young, M.</creatorcontrib><creatorcontrib>Hodgson, C. L.</creatorcontrib><creatorcontrib>on behalf of the PREDICT Study Investigators</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Higgins, A. M.</au><au>Neto, A. Serpa</au><au>Bailey, M.</au><au>Barrett, J.</au><au>Bellomo, R.</au><au>Cooper, D. J.</au><au>Gabbe, B. J.</au><au>Linke, N.</au><au>Myles, P. S.</au><au>Paton, M.</au><au>Philpot, S.</au><au>Shulman, M.</au><au>Young, M.</au><au>Hodgson, C. L.</au><aucorp>on behalf of the PREDICT Study Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of death and new disability after critical illness: a multicentre prospective cohort study</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><date>2021-07-01</date><risdate>2021</risdate><volume>47</volume><issue>7</issue><spage>772</spage><epage>781</epage><pages>772-781</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><abstract>Purpose
This study aimed to determine the prevalence and predictors of death or new disability following critical illness.
Methods
Prospective, multicentre cohort study conducted in six metropolitan intensive care units (ICU). Participants were adults admitted to the ICU who received more than 24 h of mechanical ventilation. The primary outcome was death or new disability at 6 months, with new disability defined by a 10% increase in the WHODAS 2.0.
Results
Of 628 patients with the primary outcome available (median age of 62 [49–71] years, 379 [61.0%] had a medical admission and 370 (58.9%) died or developed new disability by 6 months. Independent predictors of death or new disability included age [OR 1.02 (1.01–1.03),
P
= 0.001], higher severity of illness (APACHE III) [OR 1.02 (1.01–1.03),
P
< 0.001] and admission diagnosis. Compared to patients with a surgical admission diagnosis, patients with a cardiac arrest [OR (95% CI) 4.06 (1.89–8.68),
P
< 0.001], sepsis [OR (95% CI) 2.43 (1.32–4.47),
P
= 0.004], or trauma [OR (95% CI) 6.24 (3.07–12.71),
P
< 0.001] diagnosis had higher odds of death or new disability, while patients with a lung transplant [OR (95% CI) 0.21 (0.07–0.58),
P
= 0.003] diagnosis had lower odds. A model including these three variables had good calibration (Brier score 0.20) and acceptable discriminative power with an area under the receiver operating characteristic curve of 0.76 (95% CI 0.72–0.80).
Conclusion
Less than half of all patients mechanically ventilated for more than 24 h were alive and free of new disability at 6 months after admission to ICU. A model including age, illness severity and admission diagnosis has acceptable discriminative ability to predict death or new disability at 6 months.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00134-021-06438-7</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-9002-2075</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Intensive care medicine, 2021-07, Vol.47 (7), p.772-781 |
| issn | 0342-4642 1432-1238 |
| language | eng |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Age Analysis Anesthesiology Cardiac patients Clinical outcomes Cohort analysis Critical care Critical Care Medicine Death Diagnosis Disability Emergency Medicine Health risks Illnesses Intensive Intensive care units Life expectancy Lung transplantation Mechanical ventilation Medical research Medicine Medicine & Public Health Medicine, Experimental Mortality NCT NCT03226912 Original Pain Medicine Pediatrics Pneumology/Respiratory System Recovery (Medical) Sepsis Trauma Ventilation |
| title | Predictors of death and new disability after critical illness: a multicentre prospective cohort study |
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