Predictors of early postdischarge mortality in critically ill patients: A retrospective cohort study from the California Intensive Care Outcomes project

Abstract Purpose Existing intensive care unit (ICU) mortality measurement systems address in-hospital mortality only. However, early postdischarge mortality contributes significantly to overall 30-day mortality. Factors associated with early postdischarge mortality are unknown. Methods We performed...

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Veröffentlicht in:Journal of critical care 2011-02, Vol.26 (1), p.65-75
Hauptverfasser: Vasilevskis, Eduard E., MD, Kuzniewicz, Michael W., MD, MPH, Cason, Brian A., MD, Lane, Rondall K., MD, MPH, Dean, Mitzi L., MS, MHA, Clay, Ted, MS, Rennie, Deborah J., BA, Dudley, R. Adams, MD, MBA
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Sprache:eng
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Zusammenfassung:Abstract Purpose Existing intensive care unit (ICU) mortality measurement systems address in-hospital mortality only. However, early postdischarge mortality contributes significantly to overall 30-day mortality. Factors associated with early postdischarge mortality are unknown. Methods We performed a retrospective study of 8484 ICU patients. Our primary outcome was early postdischarge mortality: death after hospital discharge and 30 days or less from ICU admission. Cox regression models assessed the association between patient, hospital, and utilization factors and the primary outcome. Results In multivariate analyses, the hazard for early postdischarge mortality increased with rising severity of illness and decreased with full-code status (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.21-0.49). Compared with discharges home, early postdischarge mortality was highest for acute care transfers (HR, 3.18; 95% CI, 2.45-4.12). Finally, patients with very short ICU length of stay (
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2010.06.010