title: Admission factors associated with prolonged (>14 days) intensive care unit stay.
abstract: OBJECTIVE
  To describe the admission factors associated with prolonged (>14 days) intensive care unit (ICU) stay (PIS).
  
  
  METHODS
  Retrospective analysis of 3257 admissions during a 1.5-year period in a tertiary hospital. We tested the association between clinically relevant variables and PIS (>14 days) through binary logistic regression using the backward method. A Kaplan-Meier curve and the log-rank test were used to compare hospital outcomes for ICU survivors between patients with and without PIS.
  
  
  RESULTS
  In total, 6.6% of all admissions had a prolonged stay, consuming over 40% of all ICU bed-days. Illness severity; respiratory support at admission; performance status; readmission; admission from a ward, emergency room or other hospital; admission due to intracranial mass effect; severe chronic obstructive pulmonary disease; and the temperature at admission were all associated with PIS in a multivariate analysis. The created model had a good area under the curve (0.82) and was calibrated (Hosmer-Lemeshow test p = 0.431). Post hoc analysis on ICU survivors on in patients with at least two days of ICU stay yielded similar results. Hospital survival after ICU discharge was similar for patients with and without PIS (log-rank test p = 0.50).
  
  
  CONCLUSIONS
  A small number of ICU admissions consume a great proportion of ICU bed-days. Illness severity, a need for support and performance status are important predictors of PIS. Patients who survive a PIS have similar hospital mortality to patients with a shorter stay.
authors.affiliation: Intensive Care Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil; Intensive Care Unit, Emergency Medicine Discipline, University of São Paulo, São Paulo, Brazil. Electronic address: fgzampieri@gmail.com.
authors.forename: Fernando Godinho
authors.initials: FG
authors.lastname: Zampieri
authors.affiliation: Intensive Care Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil; Intensive Care Unit, Emergency Medicine Discipline, University of São Paulo, São Paulo, Brazil.
authors.forename: José Paulo
authors.initials: JP
authors.lastname: Ladeira
authors.affiliation: Intensive Care Unit, Emergency Medicine Discipline, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Park
authors.affiliation: Intensive Care Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
authors.forename: Douglas
authors.initials: D
authors.lastname: Haib
authors.affiliation: Intensive Care Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
authors.forename: Cintia Lovatto
authors.initials: CL
authors.lastname: Pastore
authors.affiliation: Intensive Care Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
authors.forename: Cristiane M
authors.initials: CM
authors.lastname: Santoro
authors.affiliation: Intensive Care Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
authors.forename: Fernando
authors.initials: F
authors.lastname: Colombari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D015897:Comorbidity; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
keywords: Critical illness; Performance status; Prolonged ICU stay