What can be learned from crude intensive care unit mortality? Methodological implications.

Journal of Critical Care
Charles WeissmanCharles L Sprung

Abstract

Demonstrate the practical range of information that can be obtained about ICU mortality/survival from limited administrative data. Prospectively collected administrative data (length-of stay, survival/mortality, referring service) from a university medical center's General ICU was subjected to retrospective analysis to demonstrate ways of presenting and analyzing mortality/survival information. 16,022 patients (87,624 patient-days) admitted over 23 years were included. 28% of all deaths occurred on ICU day 1. When considering all admissions, mortality on ICU day 1 was 2%, while the overall crude mortality rate revealed that the chances of dying during an ICU stay was 8.6%. Mortality rates in the overall population steadily increased over ICU days 1-5, plateaued during days 6 to 50, decreasing after day 50. The general surgery subgroup had a similar pattern. This contrasted with the internal medicine subgroup where mortality steadily increased over the initial 14 ICU days then plateauing at rates of 40-50%. Simple calculations using the few variables found in administrative database enhanced information provided by the crude mortality rate and demonstrated that temporal patterns of mortality change as stay lengthens. These resul...Continue Reading

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