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Intensive care unit admission has minimal impact on long-term mortality
Sean P Keenan1, Peter Dodek, Keith Chan
1Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital and University of British Columbia, Vancouver, Canada.
Objective:
To measure the association between intensive care unit (ICU) admission and both hospital and long-term mortality, separate from the effect of hospital admission alone.
Design:
Retrospective cohort study.
Setting:
All hospitals in British Columbia, Canada, during 3 fiscal years, 1994 to 1996.
Patients:
A total of 27,103 patients admitted to ICU and 41,308 (5% random sample) patients admitted to hospital but not to ICU.
Intervention:
None.
Measurements And Main Results:
Although ICU admission was an important factor associated with hospital mortality (odds ratio: 9.12; 95% confidence interval: 8.34-9.96), the association between ICU admission and mortality after discharge was relatively minimal (hazard ratio: 1.21; 95% confidence interval: 1.17-1.27) and was completely overshadowed by the effect of age, gender, and diagnosis.
Conclusions:
After controlling for the effect of hospital admission, admission to ICU has minimal independent effect on mortality after discharge.