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Patient and Population-Level Approaches to Persistent Critical Illness and Prolonged Intensive Care Unit Stays
Theodore J Iwashyna1, Elizabeth M Viglianti2
1Department of Internal Medicine, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, USA; Veterans Affairs Center for Clinical Management Research, 2800 Plymouth Drive, Building 16, 3rd floor, Ann Arbor, MI, USA; Institute for Social Research, 426 Thompson St, Ann Arbor, MI 48104, USA.
Abstract:
The differential diagnosis of prolonged intensive care unit (ICU) stays includes intrinsic patient and admitting diagnostic characteristics, occurrences during the course of critical illness, and system failures. Existing data suggest that the most common cause of prolonged ICU stay is the development of new cascading problems, which is now more related to ongoing critical illness than the original reason for ICU admission. Accepting the dynamism inherent in such a clinical course has implications for contemporary clinical care.
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