| Impact of Intensive Care Unit Organ Failures on Mortality During Five Years Following Critical Illness. | |
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MedLine Citation:
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PMID: 22837381 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Rationale The relationship between organ failure during critical illness and long-term survival is uncertain, especially among ICU survivors. Objectives To describe the relationship between individual organ failures, total organ failure burden and mortality during the five years following an episode of critical illness. Methods We studied a cohort of sequential admissions to ten Scottish ICUs (N=872). Logistic regression was used to explore independent associations between organ failures and mortality over a five-year time horizon, adjusting for potential confounders. Measurements Daily Sequential Organ Failure Assessment scores described organ dysfunction during ICU stay. The sum of the worst scores at any time point during the ICU stay for each organ system except neurological dysfunction was used to calculate total organ failure burden. Mortality was obtained from the national death register. Main Results Five year mortality was 58.2%; 34.4% of deaths occurred within 28 days. In adjusted analyses, cardiovascular (odds ratio [OR] 2.5 [95%CI 1.8-3.7]), liver (OR 2.3 [1.1-5.0]) and respiratory failure (OR 2.1 [1.3-3.5]) were independently associated with five-year mortality. Organ failure burden was strongly associated with mortality; 81% of patients in the highest tertile died during follow-up (OR 6.3 relative to lowest tertile; p<0.001). Patients surviving >12 months post-ICU were still more likely to subsequently die if they experienced greater organ failure burden in the ICU (OR 2.4, p=0.02; highest versus lowest tertile). Conclusions Cardiovascular, respiratory and liver failures during critical illness strongly predict subsequent five-year survival. Acute organ failure burden is associated with long-term mortality even among patients who survive up to one year after ICU admission. |
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Authors:
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Nazir I Lone; Timothy S Walsh |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-26 |
Journal Detail:
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Title: American journal of respiratory and critical care medicine Volume: - ISSN: 1535-4970 ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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