title: Short-term prognosis of critically ill surgical patients: the impact of duration of invasive organ support therapies.
abstract: OBJECTIVE
  We wanted to identify the importance of the duration of invasive ventilation and of renal replacement therapy for short-term prognosis of surgical patients treated in an intensive care unit (ICU).
  
  
  METHODS
  We analyzed adult patients (n = 1462) who had an ICU length of stay of more than 4 days and who were followed up until the end of the short-term phase after ICU admission. Duration of different invasive therapies was evaluated by constructing specific vectors that tested effects of time-dependent variables on outcome after a lag time of 7 days.
  
  
  RESULTS
  Eight hundred eight patients (56.6%) were still alive at the end of the short-term phase. During the short-term phase, 85.3% of the 1462 patients required invasive ventilation, and 16.1%, a continuous renal replacement therapy. Besides the underlying disease and disease severity at ICU admission, the need for invasive ventilation or renal replacement therapy was associated with poorer outcome. Duration of invasive ventilation shortened survival if treatment lasted for more than 11 days (nonlinear association). In contrast, duration of renal replacement therapy was unimportant for short-term prognosis.
  
  
  CONCLUSIONS
  Prolonged duration of invasive ventilation but not of renal replacement therapy is inversely related to short-term survival.
authors: Department of Surgery, Campus Grosshadern, Ludwig-Maximilians University Munich, D-81377 Munich, Germany.
authors: Christian P
authors: CP
authors: Schneider
authors: Jan
authors: J
authors: Fertmann
authors: Johannes
authors: J
authors: Miesen
authors: Hilde
authors: H
authors: Wolf
authors: Claudia
authors: C
authors: Flexeder
authors: Benjamin
authors: B
authors: Hofner
authors: Helmut
authors: H
authors: Küchenhoff
authors: Karl-Walter
authors: KW
authors: Jauch
authors: Wolfgang H
authors: WH
authors: Hartl
mesh_terms: D000368:Aged; D016638:Critical Illness; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000401:mortality*; D011379:Prognosis; D017582:Renal Replacement Therapy / Q000401:mortality / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000401:mortality / Q000706:statistics & numerical data*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome