title: Socioeconomic status, severity of disease and level of family members' care in adult surgical intensive care patients: the prospective ECSSTASI study.
abstract: BACKGROUND
  Low socioeconomic status (SES) is associated with increased mortality from cardiovascular disease, cancer and trauma. However, individual-level prospective data on SES in relation to health outcomes among critically ill patients admitted to intensive care units (ICU) are unavailable.
  
  
  METHODS
  In a cohort of 1,006 patients at a 24-bed surgical ICU of an academic tertiary care facility in Germany, we examined levels of SES in relation to disease severity at admission, time period of mechanical ventilation, length of stay and frequency of phone calls and visits by next-of-kin.
  
  
  RESULTS
  Patients with low SES had higher risk for Sequential Organ Failure Assessment (SOFA) score greater or equal to 5 [multivariate-adjusted odds ratio (OR) 1.49; 95% confidence interval (CI) 0.95-2.33; p = 0.029] and a trend for higher risk for Simplified Acute Physiology Score (SAPS II) greater or equal to 31 (OR 1.28; 95% CI 0.80-2.05; p = 0.086) at admission as compared with patients with high SES. When compared with men with high SES, those with low SES had greater risk for ICU treatment ≥ 5 days (multivariate-adjusted OR 1.99; 95% CI 1.06-3.74; p = 0.036) and showed a trend for a low number of visits from next-of-kin (<0.5 visits per day) (OR 1.85; 95% CI 0.79-4.30; p = 0.054). In women such associations could not be demonstrated.
  
  
  CONCLUSIONS
  Socioeconomic status is inversely related to severity of disease at admission and to length of stay in ICU, and positively associated with the level of care by next-of-kin. Whether relations differ by gender requires further examination.
authors.affiliation: Department of Anaesthesiology and Critical Care, University Hospital, 93042 Regensburg, Germany. thomas.bein@klinik.uni-regensburg.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Bein
authors.forename: Kathrin
authors.initials: K
authors.lastname: Hackner
authors.forename: Tianya
authors.initials: T
authors.lastname: Zou
authors.forename: Sybille
authors.initials: S
authors.lastname: Schultes
authors.forename: Teresa
authors.initials: T
authors.lastname: Bösch
authors.forename: Hans Jürgen
authors.initials: HJ
authors.lastname: Schlitt
authors.forename: Bernhard M
authors.initials: BM
authors.lastname: Graf
authors.forename: Matthias
authors.initials: M
authors.lastname: Olden
authors.forename: Michael
authors.initials: M
authors.lastname: Leitzmann
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003422:Critical Care / Q000706:statistics & numerical data*; D016638:Critical Illness / Q000401:mortality*; D003710:Demography; D005190:Family; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012923:Social Class; D012944:Social Support; D011795:Surveys and Questionnaires; D013689:Telephone