Prolonged Stay in Intensive Care Unit: Retrospective Analysis of Predisposing Factors and Outcome
Journal Title: Türk Yoğun Bakım Dergisi - Year 2019, Vol 17, Issue 2
Abstract
Objective: Prolonged stay in the intensive care unit (ICU) is a serious problem resulting in increased cost, resource utilization, and morbidity and mortality. This study was aimed to discuss the factors affecting the prolonged stay in ICU. Materials and Methods: The data of 219 patients between the years 2015-2019 were evaluated retrospectively. The factors affecting the prolonged stay in ICU were evaluated, including age, gender, reason of admission, length of stay, duration of mechanical ventilation, identified infection, and requirement for renal replacement therapy, tracheotomy, blood transfusion, inotropic and vasopressor agents. Results: The rate of prolonged stay in ICU was 14.56% for all admissions. The mean age of the patients was 64.74±18.18 years and the age was a predictive factor for the prolonged stay (p=0.006). The percentage of the male patient was %63.47 and 67.58% of all patients were admitted due to non-surgical reasons. Gender (p=0.73) and the reason for admission (p=0.629) were not predictive factors for prolonged stay. High APACHE II score (p=0.000), duration of mechanical ventilation (p=0.025), renal replacement therapy (p=0.000), tracheotomy (p=0.25) and inotropic and vasopressor agents requirements (p=0.000) were the other predictors of prolonged stay in ICU. The mortality rate was 67.13% in all admissions and 85.04% in patients staying more than 30 days in ICU. Mortality was significantly higher in long-term patients (p=0.004). Conclusion: Many reasons cause prolonged ICU stay and this leads to inefficient use of ICU resources. We believe that the improvements in the high dependency units and palliative care units, and widespread home care facilities will play an important role in increasing the availability of ICU beds.
Authors and Affiliations
Banu Çevik, Fatih Doğu Geyik
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