Prolonged hospitalization in intensive care unit; contributing factors and impact on mortality

Abstract

Aims: Prolonged stay in the intensive care unit (ICU) is a significant problem. It contributes to increased costs, scarcity of resources, morbidity, and mortality. This study aims to investigate the factors contributing to prolonged ICU stay and its association with mortality. Methods: We retrospectively analysed 312 patients who stayed in the ICU between January 2020 and September 2023. Patients were divided into 2 groups according to the days of ICU stay: 14 days or more (Group 1) and 30 days or more (Group 2). The effects of APACHE II, SOFA, GCS, age, gender, duration and reason for hospitalization, mechanical ventilation type and duration, renal replacement therapy, tracheotomy, blood transfusion, procalcitonin and acute phase reactants on the length of stay in the ICU were analyzed. Results: A total of 299 patients were enrolled in the study. There were 112 patients who stayed in ICU for longer than 14 days (Group 1) and 187 patients who stayed for longer than 30 days (Group 2). The mean age of Group 1 was 68.6 years and the mean age of Group 2 was 70.9 years. In Group 1, male gender predominated with 62.5%, and in Group 2, it was 56.7%. Among the patients, 29.4% were hospitalized in the ICU for surgical reasons and 70.6% for non-surgical reasons. There were statistically significant differences between the groups regarding GCS, SOFA scores and PaO2, duration of mechanical ventilation, mechanical ventilation method, ICU mortality, renal-replacement therapy, tracheostomy status, and transfusion status (p<0.05). APACHE, expected mortality, lactate, procalcitonin, albumin, pH, PaCO2, HCO3-, and GFR, the reasons for ICU admission, comorbidities, and the existence of any infection were not significantly different between the groups. Conclusion: Age, MV duration, and SOFA score were found to be associated with both prolonged ICU stay and mortality. Regardless of mortality, there was a significant difference between the two groups in terms of GCS, tracheostomy, and the need for RRT.

Keywords

• Intensive care unit
• length of stay
• mortality

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