Critical Care and Shock

Long-Term Outcome from Intensive Care. A One Year Follow-Up of Acute Admissions at Hawke’s Bay Hospital

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Background: This study aimed to collect information about long-term survival and independence of patients requiring acute hospital admissions and care in Intensive Care Unit (ICU) and High Dependency Unit (HDU) in a non tertiary setting.

Setting: An 11-bed multidisciplinary co-located ICU and HDU, a JFICM level 2 unit, providing all intensive care services for a non-tertiary (secondary) New Zealand District Health Board Hospital.

Method: All acute adult admissions presenting to ICU/HDU between 1 Jan 2001 and 31 Dec 2001 were studied. Admission demographic and physiological data was collected. From a review of the hospital records, NZ death registry, and the ICU database of published obituary notices, dates of death were identified. After the first anniversary of their initial ICU admission, discharged patients in whom death had not been confirmed, were contacted. Patients surviving ICU were surveyed to determine their independence. The age and gender adjusted annual survival for the general population was compared to observed survival following ICU/HDU admission.

Main Results: Adult acute admissions comprised 586 (68.5%) of the total of 855 ICU/HDU admissions in 2001 (86 paediatric [<15 years] and 169 elective admissions excluded). Acute adult admissions (M 49.9%; F 50.1%) had a median age of 58 years, an ICU survival of 86.3%, and a hospital survival of 82.7%. Long-term outcome was established in 94% of admissions. One year post admission 73.2% were confirmed as alive. Increased age decreased survivorship, with only 35.3% of the >85 years old group surviving one year. After ICU admission, one year survival was lower than that of the general population. Age-group matched survival was from 93% to 32% for males and 60.2% to 90.4% for females of the general population survival rate. 94.4% of survivors were independent.

Conclusions: Following acute admission, ICU patients have a lower level of survivorship than the general population, but the vast majority of the 73.2% patients that survive one year remain independent. Generally the quality of life at one year is acceptable to survivors.