Dataset Information

The epidemiology of chronic critical illness in the United States*.

ABSTRACT:

Objectives

The epidemiology of chronic critical illness is not well characterized. We sought to determine the prevalence, outcomes, and associated costs of chronic critical illness in the United States.

Design

Population-based cohort study using data from the United States Healthcare Costs and Utilization Project from 2004 to 2009.

Setting

Acute care hospitals in Massachusetts, North Carolina, Nebraska, New York, and Washington.

Patients

Adult and pediatric patients meeting a consensus-derived definition for chronic critical illness, which included one of six eligible clinical conditions (prolonged acute mechanical ventilation, tracheotomy, stroke, traumatic brain injury, sepsis, or severe wounds) plus at least 8 days in an ICU.

Interventions

None.

Measurements and main results

Out of 3,235,741 admissions to an ICU during the study period, 246,151 (7.6%) met the consensus definition for chronic critical illness. The most common eligibility conditions were prolonged acute mechanical ventilation (72.0% of eligible admissions) and sepsis (63.7% of eligible admissions). Among patients meeting chronic critical illness criteria through sepsis, the infections were community acquired in 48.5% and hospital acquired in 51.5%. In-hospital mortality was 30.9% with little change over the study period. The overall population-based prevalence was 34.4 per 100,000. The prevalence varied substantially with age, peaking at 82.1 per 100,000 individuals 75-79 years old but then declining coincident with a rise in mortality before day 8 in otherwise eligible patients. Extrapolating to the entire United States, for 2009, we estimated a total of 380,001 cases; 107,880 in-hospital deaths and $26 billion in hospital-related costs.

Conclusions

Using a consensus-based definition, the prevalence, hospital mortality, and costs of chronic critical illness are substantial. Chronic critical illness is particularly common in the elderly although in very old patients the prevalence declines, in part because of an increase in early mortality among potentially eligible patients.

SUBMITTER: Kahn JM

PROVIDER: S-EPMC7901538 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Publications

The epidemiology of chronic critical illness in the United States*.

Kahn Jeremy M JM Le Tri T Angus Derek C DC Cox Christopher E CE Hough Catherine L CL White Douglas B DB Yende Sachin S Carson Shannon S SS

Critical care medicine 20150201 2

<h4>Objectives</h4>The epidemiology of chronic critical illness is not well characterized. We sought to determine the prevalence, outcomes, and associated costs of chronic critical illness in the United States.<h4>Design</h4>Population-based cohort study using data from the United States Healthcare Costs and Utilization Project from 2004 to 2009.<h4>Setting</h4>Acute care hospitals in Massachusetts, North Carolina, Nebraska, New York, and Washington.<h4>Patients</h4>Adult and pediatric patients ...[more]

PMID: 25377018

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Dataset Information

The epidemiology of chronic critical illness in the United States*.

Objectives

Design

Setting

Patients

Interventions

Measurements and main results

Conclusions

Publications

The epidemiology of chronic critical illness in the United States*.

Similar Datasets

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