Survival after prolonged length of stay in a trauma intensive care unit

Vincent Trottier, Mark G. McKenney, Michael Beninati, Ronald Manning, Carl I Schulman

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

BACKGROUND: Intensive care unit (ICU) patients comprise a small proportion of patients in the hospital but consume a disproportionate amount of hospital resources. In our cost-conscious environment, it becomes necessary to address the overall performance of our ICUs. This study was designed to analyze survival among trauma ICU (TICU) patients with a length of stay (LOS) >1 month. METHODS: We retrospectively reviewed the prospectively collected Trauma Registry Database between January 1, 1995, and January 1, 2005, in an adult TICU from a Level I trauma center. Data on demographics, mechanism of injury, Injury Severity Score (ISS), LOS, and in-hospital survival was collected. Descriptive statistics were calculated and student's t test and comparison of proportions were performed where appropriate. Logistic regression was performed to analyze independent predictors of mortality with significance when p < 0.05. RESULTS: The initial cohort consisted of 3,556 patients with a mean LOS of 9.8 days (range, 0-274 days). Sixty-nine percent were men, mean age was 44.3 years (range, 0-104 years), and mean ISS was 18 (range, 0-75). The mechanism of injury was blunt trauma in 75%, burns in 15%, and penetrating trauma in 10%. Overall survival was 87%. A total of 339 patients had a LOS >1 month. There was no difference in survival between patients with a LOS <1 month and those with a LOS >1 month (87.1% versus 86.7%). Patients >50 years old (n = 1,251) had a longer LOS (12.5 versus 8.4 days; p < 0.001) and increased mortality (22.1% versus 8.0%; p < 0.001). Age remained an independent predictor of mortality when controlling for ISS. CONCLUSION: In our TICU population, extended LOS did not preclude a significant chance of survival. Patients >50 years old had longer LOS and increased mortality. This suggests that the utilization of resources in patients with a prolonged LOS is reasonable and justified.

Original languageEnglish
Pages (from-to)147-150
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume62
Issue number1
DOIs
StatePublished - Jan 1 2007

Fingerprint

Intensive Care Units
Length of Stay
Survival
Wounds and Injuries
Injury Severity Score
Mortality
Trauma Centers
Survival Analysis
Registries
Logistic Models
Demography
Databases
Students
Costs and Cost Analysis

Keywords

  • Age
  • Intensive care unit; Trauma
  • Length of stay
  • Survival

ASJC Scopus subject areas

  • Surgery

Cite this

Survival after prolonged length of stay in a trauma intensive care unit. / Trottier, Vincent; McKenney, Mark G.; Beninati, Michael; Manning, Ronald; Schulman, Carl I.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 62, No. 1, 01.01.2007, p. 147-150.

Research output: Contribution to journalArticle

Trottier, Vincent ; McKenney, Mark G. ; Beninati, Michael ; Manning, Ronald ; Schulman, Carl I. / Survival after prolonged length of stay in a trauma intensive care unit. In: Journal of Trauma - Injury, Infection and Critical Care. 2007 ; Vol. 62, No. 1. pp. 147-150.
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