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Long-term survival from intensive care: a review
Teresa A Williams1, Geoffrey J Dobb, Judith C Finn
1Royal Perth Hospital, 6000 Wellington, St. Perth, WA, Australia.
Intensive Care Medicine
|September 1, 2005
Summary
Determining the long-term benefit of intensive care units (ICUs) requires more research. Current studies on patient survival after ICU stays have varied methodologies, making it difficult to assess long-term outcomes.
Area of Science:
- Critical Care Medicine
- Public Health
Background:
- Assessing the long-term impact of intensive care unit (ICU) interventions is crucial for understanding patient benefit.
- Existing research on long-term survival following critical illness often lacks standardized follow-up durations and methodologies.
Purpose of the Study:
- To evaluate the necessity of prolonged patient follow-up for determining the long-term benefits of intensive care.
- To review long-term survival data of patients treated in general ICUs.
Main Methods:
- A comprehensive literature search was conducted across Medline, Embase, and Cochrane Library databases (1966-2004).
- Included studies reported patient survival for over 12 months post-discharge from general ICUs.
- Nineteen studies met the selection criteria, exhibiting variability in patient casemix, illness severity, and follow-up protocols.
Main Results:
- The average length of stay in the ICU was 5.3 days.
- Follow-up durations ranged widely from 16 months to 13 years, with varied initiation times.
- Reported ICU and hospital mortality rates ranged from 8% to 33% and 11% to 64%, respectively. Five-year mortality rates were between 40% and 58%.
Conclusions:
- Well-designed studies focusing on long-term patient outcomes are essential to definitively demonstrate the value of intensive care.
- Inconsistencies in study design, methodology, and reporting hinder the interpretation and comparison of long-term survival data.
- The optimal duration for patient follow-up after ICU discharge remains undetermined.