Late organ failures in patients with prolonged intensive care unit stays


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Abstract

Purpose:The purpose of this study was to characterize the organ failures that develop among patients with prolonged ICU stays, defined as those who spent a minimum of 14 days in an ICU.Methods:We retrospectively studied a cohort of consecutive patients from a university hospital who were in an ICU for a minimum of 14 days during 2014–2016. We calculated daily Sequential Organ Failure Assessment (SOFA) scores from admission to ICU day 14. The primary outcome was the number of new late organ failures, defined as occurring on ICU day 4 through 14.Results:In a retrospective cohort of 3777 consecutive patients in six ICUs, 50 patients had prolonged ICU stays. Of those 50, new cardiovascular failure occurred in 24 (62%) on day 4 or later; persistent mechanical ventilation was present in only 28 (56%).Conclusions:Strategies aiming to reduce the development of new late organ failures may be a novel target for preventing persistent critical illness.HIGHLIGHTSLower comorbidity was associated with persistent critical illness rather than death or earlier dischargeFour in five of long-staying ICU patients developed at least one new late organ failure, which was cardiovascular in nature in most cases.Respiratory failure and the need for mechanical ventilation was present in only half (of all long-staying ICU patientsOnly one in five patients in this cohort did not develop new late organ failures

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