title: Long-term outcome after 60 days of intensive care.
abstract: Patients with a long stay in the intensive care unit because of chronic critical illness consume many resources, and yet their outcome may be poor. We evaluated the long-term outcome of patients spending more than 60 days in the intensive care unit. We performed a retrospective cohort and prospective follow-up study of 78 patients staying more than 60 days in the 19-26 bed mixed intensive care unit of a university hospital from November 1995 to January 2003. The mortality in the intensive care unit was 38%; at 1 and 5 years it was 56% and 67%, respectively. Advanced age, prior pulmonary disease, long duration of renal replacement therapy, a low oxygenation ratio and platelet count and high Simplified Acute Physiology Score II and Sequential Organ Failure Assessment scores on day 60 influenced long-term mortality. A Simplified Acute Physiology Score II of 50 or a Sequential Organ Failure Assessment score of 8 or higher was associated with 100% mortality during follow-up. The overall 5-year survival rate of 33% suggests that prolonged intensive care may be worth the effort in certain patients.
authors.affiliation: Department of Intensive Care, Institute for Cardiovascular Research, Free University Medical Center, Amsterdam, the Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Venker
authors.forename: M
authors.initials: M
authors.lastname: Miedema
authors.forename: R J M
authors.initials: RJ
authors.lastname: Strack van Schijndel
authors.forename: A R J
authors.initials: AR
authors.lastname: Girbes
authors.forename: A B J
authors.initials: AB
authors.lastname: Groeneveld
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D004812:Epidemiologic Methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012720:Severity of Illness Index; D016896:Treatment Outcome