Five-year survival after intensive care--comparison of 12,180 patients with the general population. Finnish ICU Study Group

Abstract

Objectives: A) To examine the long-term survival of critically ill patients compared with the general population in a nationwide sample of patients requiring intensive care; and b) to analyze long-term survival stratified by specific diagnostic subgroups.

Design: Prospective, inception cohort study.

Setting: Twenty-five Finnish Intensive care units (ICUs) at 17 hospitals, including 13 ICUs in five tertiary care centers.

Patients: A consecutive sample of 12,180 adult patients who were admitted to ICUs in 1987. The sample was further divided into seven diagnostic subgroups.

Interventions: None.

Measurements and main results: Vital status at 5 yrs after admission to an ICU was examined and compared to the age- and gender-adjusted survival of Finland's general population. Among ICU patients, the 5-yr mortality rate was 3.3 times that of Finland's general population (95% confidence interval 3.0 to 3.4). At 2 yrs, the survival rate paralleled that of the general population. At 5 yrs, the relative survival rate of the ICU patients was 66.7%. Cancer was a strong determinant of a poor outcome in multivariate analysis (relative risk 3.17; 95% confidence interval 2.86 to 3.51). The 5-yr mortality rate of the ICU patients compared with the general population was highest among patients admitted to the ICU after intoxication. Trauma victims and patients admitted to the ICU with a cardiovascular diagnosis reached the risk of death of the general population in the shortest time.

Conclusions: ICU patients reached a life expectancy similar to the general population, on average, 2 yrs after admission. The time after which the survival parallels that of the general population depends, however, on the diagnostic category.