Clinician perception of long-term survival at the point of critical care discharge: a prospective cohort study.
Adolescent
Adult
Aged
Aged, 80 and over
Attitude of Health Personnel
Cohort Studies
Critical Care
Critical Illness
/ mortality
England
/ epidemiology
Female
Follow-Up Studies
Health Status Indicators
Hospital Mortality
Humans
Intensive Care Units
Male
Middle Aged
Patient Discharge
Postoperative Period
Prognosis
Prospective Studies
Risk Assessment
/ methods
Survival Analysis
Young Adult
critical care
death
rehabilitation
survival analysis
Journal
Anaesthesia
ISSN: 1365-2044
Titre abrégé: Anaesthesia
Pays: England
ID NLM: 0370524
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
accepted:
04
03
2020
pubmed:
5
5
2020
medline:
3
7
2020
entrez:
5
5
2020
Statut:
ppublish
Résumé
Critical care survivors suffer persistent morbidity and increased risk of mortality as compared with the general population. Nevertheless, there are no standardised tools to identify at-risk patients. Our aim was to establish whether the Sabadell score, a simple tool applied by the treating clinician upon critical care discharge, was independently associated with 5-year mortality through a prospective observational cohort study of adults admitted to a general critical care unit. The Sabadell score, which is a measure of clinician-assigned survival perception, was applied to all patients from September 2011 to December 2017. The primary outcome was 5-year mortality, assessed using a multivariable flexible parametric survival analysis adjusted for baseline characteristics and clinically relevant covariates. We studied 5954 patients with a minimum of 18 months follow-up. Mean (SD) age was 59.5 (17.0) years and 3397 (57.1%) patients were men. We categorised 2287 (38.4%) patients as Sadabell 0; 2854 (47.9%) as Sadabell 1; 629 (10.5%) as Sadabell 2; and 183 (3.1%) as Sadabell 3. Adjusted hazard ratios for mortality were 2.1 (95%CI 1.9-2.4); 4.0 (95%CI 3.4-4.6); and 21.0 (95%CI 17.2-25.7), respectively. Sabadell 3 patients had 99.9%, 99.5%, 98.5% and 87.4% mortality at 5 years for patients in the age brackets ≥ 80, 60-79, 40-59 and 16-39 years, respectively. Sabadell 2 patients had 71.0%, 52.7%, 44.8% and 23.7% 5-year mortality for these same age categories. The Sabadell score was independently associated with 5-year survival after critical care discharge. These findings can be used to guide provision of increased support for patients after critical care discharge and/or informed discussions with patients and relatives about dying to ascertain their future wishes.
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
896-903Subventions
Organisme : NIHR Post-Doctoral Fellowship
ID : PDF-2018-11-ST2-006
Pays : International
Informations de copyright
© 2020 Association of Anaesthetists.
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