Homeless Patients in the ICU: An Observational Propensity-Matched Cohort Study

Critical Care Medicine
Naïke BigéBertrand Guidet

Abstract

To describe epidemiology and outcome of critically ill homeless patients, as compared with those of nonhomeless patients. Homeless and nonhomeless admissions were matched on the basis of a 1:4 ratio, using a propensity score-based procedure involving age, sex, date, and main diagnosis at ICU admission. A 18-bed closed medical ICU of a French tertiary care university hospital. All consecutive admissions from July 2000 to December 2012. None. There were 421 homeless and 9,353 nonhomeless admissions. Considering homeless admissions, 50% patients had no health insurance, 56% had no financial resource, 91% were socially isolated, and 69% lived in street. In a multivariable analysis of homeless admissions including age, sex, and Simplified Acute Physiology Score II, living in street was significantly associated with hospital mortality (odds ratio=2.94; 95% CI, 1.30-7.10; p=0.012). As compared with nonhomeless, homeless admissions more frequently concerned men (89% vs 57%; p<0.0001) and younger patients (49 yr [43-57] vs 62 yr [46-76]; p<0.0001), whereas Simplified Acute Physiology Score II (37 [24-50] vs 37 [25-52]; p=0.99) and distribution of the number of organ supports (p=0.49) were similar. ICU mortality concerned 19.1% and 18% o...Continue Reading

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