| Title: | Multimorbidity and Its Relationship With Long-Term Outcomes After Critical Care Discharge A Prospective Cohort Study |
| Journal: | CHEST Journal |
| Published: | 18 Jun 2021 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/34153342/ |
| DOI: | https://doi.org/10.1016/j.chest.2021.05.069 |
| URL: | http://journal.chestnet.org/article/S0012369221011284/pdf |
Publication 13791
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Abstract
BACKGROUND: Survivors of critical illness have poor long-term outcomes with subsequent increases in health care utilization. Less is known about the interplay between multimorbidity and long-term outcomes.</p>
RESEARCH QUESTION: How do baseline patient demographics impact mortality and health care utilization in the year after discharge from critical care?</p>
STUDY DESIGN AND METHODS: Using data from a prospectively collected cohort, we used propensity score matching to assess differences in outcomes between patients with a critical care encounter and patients admitted to the hospital without critical care. Long-term mortality was examined via nationally linked data as was hospital resource use in the year after hospital discharge. The cause of death was also examined.</p>
RESULTS: This analysis included 3,112 participants. There was no difference in long-term mortality between the critical care and hospital cohorts (adjusted hazard ratio, 1.09; 95% CI, 0.90-1.32; P = .39). Prehospitalization emotional health issues (eg, clinical diagnosis of depression) were associated with increased long-term mortality (hazard ratio, 1.49; 95% CI, 1.14-1.96; P < .004). Health care utilization was different between the two cohorts in the year after discharge with the critical care cohort experiencing a 29% increased risk of hospital readmission (OR, 1.29; 95% CI, 1.11-1.50; P = .001).</p>
INTERPRETATION: This national cohort study has demonstrated increased resource use for critical care survivors in the year after discharge but fails to replicate past findings of increased longer-term mortality. Multimorbidity, lifestyle factors, and socioeconomic status appear to influence long-term outcomes and should be the focus of future research.</p>
19 Keywords
- Aged
- Cohort Studies
- Critical Care
- Critical Illness
- Depression
- Female
- Humans
- Life Style
- Long Term Adverse Effects
- Male
- Multimorbidity
- Patient Discharge
- Patient Readmission
- Risk Assessment
- Risk Factors
- Scotland
- Social Class
- Subacute Care
- Survivors
8 Authors
- Joanne McPeake
- Tara Quasim
- Philip Henderson
- Alastair H. Leyland
- Nazir I. Lone
- Matthew Walters
- Theodore J. Iwashyna
- Martin Shaw
1 Application
| Application ID | Title |
|---|---|
| 57617 | Understanding the social outcomes of survivors of critical illness: a cross sectional population study of UK Biobank participants |
Enabling scientific discoveries that improve human health