One-year survival after admission in the intensive care unit: a retrospective cohort study

Barisich, Patrick Sepúlveda; Ramírez-Santana, Muriel

doi:10.1590/1806-9282.20240463

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Revista da Associação Médica Brasileira

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Sumário

Original Article • Rev. Assoc. Med. Bras. 70 (9) • 2024 • https://doi.org/10.1590/1806-9282.20240463 copy

One-year survival after admission in the intensive care unit: a retrospective cohort study

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

INTRODUCTION:

Improving survival is the objective of intensive care units. Various factors affect long-term outcomes. The objective was to explore survival and the associated factors 1 year after admission to the intensive care unit.

METHOD:

This is an observational, descriptive, and analytical study in a retrospective cohort of adults admitted to an intensive care unit at a regional hospital during the first semester of 2022. Records of 218 patients from an anonymized database were analyzed.

RESULTS:

The average age was 61 years, and the average APACHE II score was 15 points (24% expected mortality). Survival 1 year after admission was 57.8%. Factors associated with 1-year survival in the Cox regression model were age and APACHE II. The univariate analysis showed that the cancer was significantly associated with lethality after 1 year (OR 10.55; 95%CI 1.99–55.76).

CONCLUSION:

One-year survival after intensive care unit decreases by 16.1%. Factors that significantly reduced survival were old age, severity, and oncologic cause at admission.

KEYWORDS:
Survival; Retrospective studies; Intensive care units; Mechanical ventilation; APACHE

Variables	Categories	n	Percentage (%)
Age (years)	18–29	12	5.5
	30–49	40	18.4
	50–64	61	27.9
	65–80	77	35.4
	>80	28	12.8
Sex	Feminine	101	46.3
Sex	Masculine	117	53.7
Cause of admission to the ICU	Surgery	55	25.2
	Respiratory	44	20.2
	COVID-19	36	16.5
	Neurologic	30	13.8
	Medical	28	12.8
	Oncologic	13	6.0
	Cardiologic	6	2.8
	Another cause	6	2.8
Number of comorbidities	1 comorbidity	74	33.9
Number of comorbidities	2 comorbidities	5	2.9
Exposure to invasive devices	MV	184	84.4
	Urinary catheter	208	95.4
	Central venous catheter	199	91.3
	Hemofiltration or hemodialysis	33	15.1
Survival time	ICU	161	73.9
	Hospital	148	67.9
	30 days	157	72
	3 months	140	64.2
	6 months	135	61.9
	1 year	126	57.8
		Mean	Min–max
Days of admission or MV	Days of MV	7.5	0–53
	Days at ICU admission	11.46	1–53
	Days at hospital after ICU	17.6	–
	Total days of admission	29.1	–
APACHE II	% expected mortality	15.33	2–35

Variables	Raw risk of death			Cox regression model
Variables	OR	95%CI	p-value	OR	95%CI	p-value
Sex	0.73	0.41–1.29	0.733	1.33	0.88–2.01	0.175
Age	1.04	1.02–1.05	<0.001	1.02	1–1.03	0.018
Mechanical ventilation (yes)	0.82	0.38–1.74	0.611	0.77	0.42–1.4	0.386
Days of stay in ICU	1	0.97–1.02	0.973	–	–	–
APACHE II	1.13	1.08–1.19	<0.001	1.06	1.03–1.10	<0.01
Admission due to cancer	8.42	1.81–38.97	0.01	–	–	–

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[1] *Corresponding author:
mramirezs@ucn.cl