Post-ICU mortality in critically ill infected patients: an international study.
OBJECTIVE
To determine the incidence and risk factors for post-ICU mortality in patients with infection.


METHODS
International observational cohort study including 28 ICUs in eight countries.


METHODS
All 1,872 patients discharged alive from the ICU over a 1-year period were screened for infection at ICU admission and daily throughout the ICU stay. Outcomes at ICU and hospital discharge were recorded.


RESULTS
Post-ICU death occurred in 195 (10.4%) patients and was associated in the multivariable analysis with age, chronic respiratory failure, immunosuppression, cirrhosis, Simplified Acute Physiology Score II on the first day with infection, and LOD score at ICU discharge. Post-ICU death was more common among medical patients and patients with hospital-acquired infection or microbiologically documented infection and was less common in patients with pneumonia.


CONCLUSIONS
Post-ICU death in patients with infection was within previously reported ranges in overall ICU populations. The main risk factors were patient and infection characteristics, severity at ICU admission, and persistent organ dysfunction at ICU discharge. Further interventions such as further ICU management, discharge to a step-down unit, or follow-up by intensivists on the ward should be evaluated in patients with a high risk of post-ICU mortality.
Azoulay
Elie
E
Intensive Care Unit, Saint-Louis Hospital, Paris 7 University, 1 Avenue Claude, Vellefaux, 75010 Paris, France.
Alberti
Corinne
C
Legendre
Isabelle
I
Buisson
Christian Brun
CB
Le Gall
Jean Roger
JR
D018806:APACHE; D000328:Adult; D000368:Aged; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology / Q000401:mortality*; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012307:Risk Factors; D018805:Sepsis / Q000401:mortality*