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Comparative Study
. 2009;13(5):R154.
doi: 10.1186/cc8054. Epub 2009 Sep 24.

Characteristics and outcomes of trauma patients with ICU lengths of stay 30 days and greater: a seven-year retrospective study

Adrian W Ong  1 , Laurel A Omert, Diane Vido, Brian M Goodman, Jack Protetch, Aurelio Rodriguez, Elan Jeremitsky
Affiliations
Comparative Study

Characteristics and outcomes of trauma patients with ICU lengths of stay 30 days and greater: a seven-year retrospective study

Adrian W Ong et al. Crit Care. 2009.

Abstract

Introduction: Prolonged intensive care unit lengths of stay (ICU LOS) for critical illness can have acceptable mortality rates and quality of life despite significant costs. Only a few studies have specifically addressed prolonged ICU LOS after trauma. Our goals were to examine characteristics and outcomes of trauma patients with LOS >or= 30 days, predictors of prolonged stay and mortality.

Methods: All trauma ICU admissions over a seven-year period in a level 1 trauma center were analyzed. Admission characteristics, pre-existing conditions and acquired complications in the ICU were recorded. Logistic regression was used to identify independent predictors of prolonged LOS and predictors of mortality among those with prolonged LOS after univariate analyses.

Results: Of 4920 ICU admissions, 205 (4%) had ICU LOS >30 days. These patients were older and more severely injured. Age and injury severity score (ISS) were associated with prolonged LOS. After logistic regression analysis, sepsis, acute respiratory distress syndrome, and several infectious complications were important independent predictors of prolonged LOS. Within the group with ICU LOS >30 days, predictors of mortality were age, pre-existing renal disease as well as the development of renal failure requiring dialysis. Overall mortality was 12%.

Conclusions: The majority of patients with ICU LOS >or= 30 days will survive their hospitalization. Infectious and pulmonary complications were predictors of prolonged stay. Further efforts targeting prevention of these complications are warranted.

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Figures

Figure 1
Figure 1
Composition of the study groups. ILOS<30 = patients with intensive care unit (ICU) length of stay less than 30 days; ILOS>30 = patients with ICU length of stay greater than or equal to 30 days.
Figure 2
Figure 2
Distribution of length of stay of all trauma ICU patients in the study period. X axis = length of stay (days); Y axis = percentage of all trauma intensive care unit (ICU) patients.
See this image and copyright information in PMC

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