title: Short- and long-term prognosis of critically-ill patients referred to the ICU from the Emergency Department of a tertiary hospital.
abstract: OBJECTIVE
  A frequent source of critically-ill patients admitted to the ICU is the Emergency Department. It is essential to analyse the short-term prognosis of these patients, but also their evolution after their discharge from the hospital, since this is one of the major concerns of these patients. The aim of this study is to describe the epidemiological characteristics of patients admitted to the ICU from the Emergency Department and to analyse their outcome.
  
  
  METHODS
  This consisted of an observational prospective cohorts study which included 269 Emergency Department patients consecutively admitted to the ICU over an 18-month period. Factors associated with hospital mortality were presented as an odds ratio (OR) and factors associated with long-term mortality were presented as a hazard ratio (HR). A P-value lower than .05 was accepted as significant. The overall survival was analysed on the basis of the Kaplan-Meier curves.
  
  
  RESULTS
  Hospital mortality was 15%, ICU complications where the variables with the greatest impact on short-term mortality: acute renal failure (OR 22.7) and respiratory distress syndrome (OR 51.2). After hospital discharge, the cumulative mortality at 12, 24 and 36 months was 6, 11 and 15%, respectively. The degree of functional dependence (HR 3.7), cancer (HR 3.4) and arrhythmias (HR 2.4) were factors related to long-term mortality.
  
  
  CONCLUSIONS
  The short-term outcome of ICU patients is related to age and comorbidity, but more significantly to the characteristics of the acute illness. However, the long-term outcome is more closely associated with the patients' characteristics.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: rennygg@hotmail.com.
authors.forename: Renata
authors.initials: R
authors.lastname: García-Gigorro
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: Helena
authors.initials: H
authors.lastname: Dominguez Aguado
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: Jesús Abelardo
authors.initials: JA
authors.lastname: Barea Mendoza
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: Rubén
authors.initials: R
authors.lastname: Viejo Moreno
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: Jose Angel
authors.initials: JA
authors.lastname: Sánchez Izquierdo
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Montejo-González
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000401:mortality* / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012017:Referral and Consultation; D012307:Risk Factors; D013030:Spain; D015996:Survival Rate; D062606:Tertiary Care Centers; D055815:Young Adult
keywords: Cuidados intensivos; Emergency Department; Hospital mortality; Intensive care; Long-term mortality; Mortalidad a largo plazo; Mortalidad hospitalaria; Servicio de Urgencias