Identification of factors associated with prolonged stay in the intensive care unit Yoğun bakım ünitesinde uzun süre kalış ile ılişkili faktörlerin belirlenmesi


Sabaz M. S., Aşar S.

Medical Journal of Bakirkoy, cilt.17, sa.3, ss.233-242, 2021 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.4274/bmj.galenos.2021.96658
  • Dergi Adı: Medical Journal of Bakirkoy
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CINAHL, EMBASE, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.233-242
  • Anahtar Kelimeler: Intensive care units, length of stay, mechanical ventilation, mortality
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: This study aimed to determine the factors associated with prolonged intensive care unit length of stay (ICU-LOS), which is increasingly common in ICU, and to evaluate its effect on patient outcomes. Methods: This retrospective study was evaluated by obtaining data of 5,022 patients who were followed in the ICU of a tertiary education and research hospital between January 2014 and January 2021 and met the research criteria in electronic environment. Results: Patients were divided into two groups as patients with ICU-LOS <14 days (n=4,083, 81.3%) and patients with ICU-LOS ≥14 days (n=939, 18.7%). Sepsis and pulmonary diseases were more common in the prolonged ICU-LOS group than in the non-prolonged ICU-LOS group (p<0.05). While 61.8% (2,525) in the non-prolonged ICU-LOS group needed mechanical ventilator support, this rate increased to 97.4% (915) in the prolonged ICU-LOS group (p<0.001). The duration of MV was higher in the prolonged ICU-LOS group [20.3 (14.9-29.2)] than in the non-prolonged ICU-LOS group [3.4 (1.7-6.2)] (p>0.001). Although 18.7% of the patients had prolonged ICU-LOS, they consumed 66.3% and 59.7% of all mechanical ventilator days and ICU hospitalization days, respectively. ICU mortality was higher in the prolonged ICU-LOS group (n=376; 40%) than in the non-prolonged ICU-LOS group (n=1219; 29.9%). The development of acute kidney injury (odds ratio (OR): 1,807; 95% confidence interval (CI) 1,434-2,277), development of pressure sores (OR: 3,572; 95% CI: 2,663-4,792), total parenteral nutrition use (OR: 2,014; 95% CI: 1,639-2,475), increase in body mass index (OR: 1,015; 95% CI: 1.001-1.031), and mechanical power increase (OR: 1.041; 95% CI: 1.002-1.082) were associated with prolonged ICU-LOS (OR: 1.015; 95% CI: 1.001-1.031). Conclusion: Prolonged ICU-LOS is associated with increased costs, use of resources, and morbidity and mortality.