The Clinical Profile of Chronically Critically Ill Patients
Author Information
Author(s): Estenssoro Elisa, Reina Rosa, Canales Héctor S, Saenz María Gabriela, Gonzalez Francisco E, Aprea María M, Laffaire Enrique, Gola Victor, Dubin Arnaldo
Primary Institution: Servicio de Terapia Intensiva, Hospital Interzonal General San Martín, La Plata, Buenos Aires, Argentina
Hypothesis
What are the epidemiological features, clinical complications, infectious profiles, and outcomes of chronically critically ill patients?
Conclusion
Chronically critically ill patients are severely ill, often suffering from ARDS, shock, and organ failure, but their overall prognosis is similar to that of other ICU patients.
Supporting Evidence
- 12% of ICU patients were classified as chronically critically ill.
- CCI patients had higher APACHE II scores indicating greater severity of illness.
- ARDS was present in 84% of CCI patients compared to 44% in non-CCI patients.
- Observed mortality was similar between CCI and non-CCI patients at 32% and 35%, respectively.
- Independent predictors of progression to CCI included ARDS on admission and APACHE II scores.
Takeaway
Some patients get really sick and need help for a long time, but they can still get better, just like other patients.
Methodology
This was a prospective cohort study of patients admitted to an ICU over three years, recording various clinical and demographic data.
Potential Biases
Selection bias may occur as physicians might preferentially tracheostomize patients expected to survive.
Limitations
The study is observational and conducted in a single ICU, which may limit generalizability.
Participant Demographics
The study included 785 patients, with 95 identified as chronically critically ill, similar in age and gender to non-CCI patients.
Statistical Information
P-Value
p<0.001
Confidence Interval
95% confidence intervals were calculated for odds ratios.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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