title: Epidemiology of critical care syndromes, organ failures, and life-support interventions in a suburban US community.
abstract: BACKGROUND
  ICU services represent a significant and increasing proportion of medical care. Population-based epidemiologic studies are essential to inform physicians and policymakers about current and future ICU demands. We aimed to determine the incidence of critical care syndromes, organ failures, and life-support interventions in a defined US suburban community with unrestricted access to critical care services.
  
  
  METHODS
  This population-based observational cohort from January 1 to December 31, 2006, in Olmsted County, Minnesota, included all consecutive critically ill adult residents admitted to the ICU. Main outcomes were incidence of critical care syndromes, life-support interventions, and organ failures as defined by standard criteria. Incidences are reported per 100,000 population (95% CIs) and were age adjusted to the 2006 US population.
  
  
  RESULTS
  A total of 1,707 ICU admissions were identified from 1,461 patients. Incidences of critical care syndromes were respiratory failure, 430 (390-470); acute kidney injury, 290 (257-323); severe sepsis, 286 (253-319); all-cause shock, 194 (167-221); acute lung injury, 86 (68-105); all-cause coma, 43 (30-55); and overt disseminated intravascular coagulation, 18 (10-26). Incidence of mechanical ventilation was invasive, 310 (276-344); noninvasive, 180 (154-206); vasopressors and inotropes, 183(155-208). Renal replacement therapy incidence was 96 (77-116). Of the cohort, 1,330 patients (91%) survived to hospital discharge. Short- and long-term survival decreased by the number of failing organs.
  
  
  CONCLUSIONS
  In a suburban US community with high access to critical care services, cumulative incidences of critical care syndromes and life-support interventions were higher than previously reported. The results of this study have important implications for future planning of critical care delivery.
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN. Electronic address: cartinceba.rodrigo@mayo.edu.
authors: Rodrigo
authors: R
authors: Cartin-Ceba
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia.
authors: Marija
authors: M
authors: Kojicic
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Guangxi
authors: G
authors: Li
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Anesthesiology, Mayo Clinic, Rochester, MN.
authors: Daryl J
authors: DJ
authors: Kor
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Jaise
authors: J
authors: Poulose
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Vitaly
authors: V
authors: Herasevich
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN.
authors: Rahul
authors: R
authors: Kashyap
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Cesar
authors: C
authors: Trillo-Alvarez
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Javier
authors: J
authors: Cabello-Garza
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Rolf
authors: R
authors: Hubmayr
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Edward G
authors: EG
authors: Seferian
authors: Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C), Mayo Clinic, Rochester, MN; Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Ognjen
authors: O
authors: Gajic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006764:Hospitals, Community; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D008020:Life Support Care / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012424:Rural Population; D013577:Syndrome