Cause of death in intensive care patients within 2 years of discharge from hospital.
OBJECTIVE
To identify intensive care patients dying within 2 years of discharge from hospital and assess whether the cause of death was related to the diagnosis at hospital discharge.


METHODS
A retrospective cohort study of all patients admitted to the intensive care unit at Wellington Hospital, New Zealand, between 1 July 2001 and 30 June 2003, using data from the ICU database. Mortality data were obtained from the New Zealand National Death Registry.


METHODS
Death within 2 years of hospital discharge; cause of death and its relation to the hospital discharge diagnosis.


RESULTS
Of 1984 patients discharged home, 193 died within 2 years. One-year and 2-year survival rates were 93.8% and 90.3%, respectively. Two-year mortality rates were 4.6% in elective cardiac surgical patients, 19.7% in elective noncardiac surgical patients, 16.9% in acute patients admitted from the operating room, and 10.2% in other acute patients. Among the 193 patients who died after discharge, 124 deaths (64.2%) were related to the diagnosis at hospital discharge. The mortality rate in this group was highest at 3 months (90.5%) and lower at 6 months (75.0%), then averaged 51.4% after 6 months. Cause of death was related to discharge diagnosis in 46.2% of elective cardiac surgical patients, 66.6% of elective non-cardiac surgical patients, 60.5% of acute patients admitted from the operating room, and 75.4% of other acute patients. Cancer was the cause of death in 34.2% of elective cardiac surgical patients, 66.7% of elective non-cardiac surgical patients, 48.8% of acute patients admitted from the operating room, and 29.0% of other acute patients.


CONCLUSIONS
Survival rates of ICU patients after discharge from hospital are high. Deaths are closely related to the discharge diagnosis only in the first 6 months after discharge. Cancer is a common cause of death. Elective non-cardiac surgical patients have the worst outcomes.
Intensive Care Unit, Wellington Hospital, Wellington, New Zealand. Peter.hicks@ccdhb.org.nz
Peter R
PR
Hicks
Diane M
DM
Mackle
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016638:Critical Illness; D003953:Diagnosis-Related Groups; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D009520:New Zealand / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D055815:Young Adult