Key result
Non-surgical ICU admission in 2020-2021 is linked to ~41% higher 1-year mortality versus 2012-2013.
Why the study?
The study aimed to elucidate the prognostic impact of temporal trends in non-surgical patients requiring intensive care over a 10-year period.
Does the year of admission impact long-term prognosis in non-surgical patients requiring intensive care?
Cohort (n=4,276)
Does the year of admission impact long-term prognosis in non-surgical patients requiring intensive care?
Effect estimate: HR 1.409 (95% CI 1.115-1.779)
p-value: p=0.004
The severity and long-term mortality of non-surgical intensive care patients have increased over the past decade, highlighting the need for enhanced post-ICU care.
Higher long-term mortality in recent non-surgical ICU admissions may signal rising severity; leaves open whether targeted post-ICU strategies improve outcomes.
BACKGROUND: The aim of the present study is to elucidate prognostic impact of temporal trends of non-surgical patients requiring intensive care over a 10-year period. METHODS AND RESULTS: A total of 4276 non-surgical patients requiring intensive care from 2012 to 2021 were enrolled. Patients' backgrounds, in-hospital management, and prognoses were compared between five groups [2012-2013 (n = 825), 2014-2015 (n = 784), 2016-2017 (n = 864), 2018-2019 (n = 939), and 2020-2021 (n = 867)]. During the study period, mean age significantly increased from 69 years in 2012-2013 to 72 years in 2020-2021. Mean Acute Physiology and Chronic Health Evaluation scores significantly increased from 10 points in 2012-2013 to 12 points in 2020-2021. The median duration of intensive care unit stays increased from 3 to 4 days. Kaplan-Meier survival curve analysis showed that survival rates during 30- and 365-days were significantly lower in 2020-2021 than in 2012-2013, but it was not significantly different by a Cox proportional hazards regression model in 30 days. A Cox proportional hazards regression model revealed that the risks of 365-day all-cause death were significantly higher in patients enrolled in 2016-2017 (HR: 1.324, 95 % CI: 1.042-1.680, p = 0.021), in 2018-2019 (HR: 1.329, 95 % CI: 1.044-1.691, p = 0.021), and in 2020-2021 (HR: 1.409, 95 % CI: 1.115-1.779, p = 0.004). CONCLUSION: The condition of patients requiring intensive care is becoming more critical year by year, leading to poorer long-term prognoses despite improvements in treatment strategies. These findings emphasize the importance of additional care management after admission into non-surgical intensive care units, particularly for the aging society of Japan.
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Shigihara et al. (2024) conducted a cohort in Non-surgical patients requiring intensive care (n=4,276). Admission in 2020-2021 vs. Admission in 2012-2013 was evaluated on 365-day all-cause death (HR 1.409, 95% CI 1.115-1.779, p=0.004). Admission to a non-surgical intensive care unit in 2020-2021 was associated with a higher risk of 365-day all-cause death compared to 2012-2013 (HR 1.409; 95% CI 1.115-1.779; p=0.004).
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