Key result
Day 3 respiratory and renal failures linked to highest ICU mortality based on admission type.
Why the study?
Organ dysfunction or failure after the first days of ICU treatment and subsequent mortality with respect to the type of ICU admission is poorly elucidated.
Does the type of ICU admission (medical vs. scheduled surgery vs. unscheduled surgery) affect the evolution of organ failure and subsequent mortality risk?
Population
23,795 ICU patients from the DIVI registry
Comparison
Medical vs scheduled surgery vs unscheduled surgery ICU admissions
Design
Retrospective cohort study
Authors
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ICU admission type may refine post-72h organ-failure risk assessment; leaves open whether tailored interventions reduce mortality.
Cohort (n=23,795)
Yes
Does the type of ICU admission (medical vs. scheduled surgery vs. unscheduled surgery) affect the evolution of organ failure and subsequent mortality risk?
Odds Ratio: 2.545 (95% CI 2.295–2.822)
p-value: p=<0.001
The dynamic evolution of organ dysfunction and mortality risk differs significantly based on the type of ICU admission, highlighting the need to account for admission type to prevent systematic bias in multi-center trials.
Bingold et al. (2015) conducted a cohort in Critical illness requiring ICU admission (n=23,795). Type of ICU admission and individual organ failure vs. Other admission types and absence of specific organ failure was evaluated on ICU mortality associated with cardiovascular failure on day 3 (OR 2.545, 95% CI 2.295-2.822, p=<0.001). The risk of ICU mortality associated with specific organ failures on day three differed significantly by admission type, with respiratory failure posing the highest risk for medical and scheduled surgery patients, and renal failure for surgical patients.
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