title: Use of life support in acutely admitted ICU patients. An international cohort study.
abstract: BACKGROUND
  Use of life support in intensive care unit (ICU) patients has been associated with increased risk of poor outcome. The prognostic importance of the duration of support is less studied. We assessed the use of life support and the association between its duration and 90-day mortality in a contemporary cohort of acutely admitted adult ICU patients.
  
  
  METHODS
  We performed a post-hoc analysis of the SUP-ICU 7-day inception cohort study (n = 1034), which was conducted in 97 ICUs in 11 countries. We included patients with an ICU stay of 3 days or more. We assessed the use of life support during the first 3 days in ICU and the crude and adjusted association between its duration and 90-day mortality using logistic regression analyses.
  
  
  RESULTS
  We included 690 patients; their 90-day mortality was 23%. During the first 3 days in ICU mechanical ventilation was used in 65%, vasopressors/inotropes in 57% and renal replacement therapy in 13%. Renal replacement therapy for 3 days or more was associated with a higher 90-day mortality as compared with 1 day of renal replacement therapy [odds ratio 6.5 (95% confidence interval 1.3 to 32.8)]. For mechanical ventilation and vasopressors/inotropes the odds ratios were 2.2 [0.9 to 5.3] and 1.2 [0.5 to 2.6], respectively.
  
  
  CONCLUSIONS
  Among acutely admitted adult ICU patients, a higher number of days of renal replacement therapy in the initial ICU stay were associated with increased risk of death within 90 days. We did not observe such an association for mechanical ventilation or vasopressor/inotropic therapy.
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: T S
authors.identifier: http://orcid.org/0000-0002-1840-1596
authors.initials: TS
authors.lastname: Meyhoff
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Krag
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: P B
authors.initials: PB
authors.lastname: Hjortrup
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Perner
authors.affiliation: Department of Intensive Care 4131, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
authors.forename: M H
authors.identifier: http://orcid.org/0000-0002-6378-9673
authors.initials: MH
authors.lastname: Møller
mesh_terms: D000208:Acute Disease; D000368:Aged; D044362:Australasia; D002170:Canada; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods* / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008020:Life Support Care / Q000379:methods* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents