Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/2573
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dc.contributorLing, R.en_US
dc.contributorBonavia, W.en_US
dc.contributorReddy, M.en_US
dc.contributorPilcher, D.en_US
dc.contributorSubramaniam, A.en_US
dc.date.accessioned2024-06-14T12:14:03Z-
dc.date.available2024-06-14T12:14:03Z-
dc.date.issued2024-
dc.identifier.govdoc02526en_US
dc.identifier.urihttp://hdl.handle.net/11054/2573-
dc.descriptionIncludes data from Ballarat Health Services and Wimmera Health Care Groupen_US
dc.description.abstractOBJECTIVES: A nontrivial number of patients in ICUs experience persistent critical illness (PerCI), a phenomenon in which features of the ICU course more consistently predict mortality than the initial indication for admission. We aimed to describe PerCI among patients with critical illness caused by COVID-19, and these patients’ short- and long-term outcomes. DESIGN: Multicenter retrospective cohort study. SETTING: Australian and New Zealand Intensive Care Society Adult Patient Database of 114 Australian ICUs between January 1, 2020, and March 31, 2022. PATIENTS: Patients 16 years old or older with COVID-19, and a documented ICU length of stay. EXPOSURE: The presence of PerCI, defined as an ICU length of stay greater than or equal to 10 days. MEASUREMENTS: We compared the survival time up to 2 years from ICU admission using time-varying robust-variance estimated Cox proportional hazards models. We further investigated the impact of PerCI in subgroups of patients, stratifying based on whether they survived their initial hospitalization. MAIN RESULTS: We included 4961 patients in the final analysis, and 882 patients (17.8%) had PerCI. ICU mortality was 23.4% in patients with PerCI and 6.5% in those without PerCI. Patients with PerCI had lower 2-year (70.9% [95% CI, 67.9–73.9%] vs. 86.1% [95% CI, 85.0–87.1%]; p < 0.001) survival rates compared with patients without PerCI. Patients with PerCI had higher mortality (adjusted hazards ratio: 1.734; 95% CI, 1.388–2.168); this was consistent across several sensitivity analyses. When analyzed as a nonlinear predictor, the hazards of mortality were inconsistent up until 10 days, before plateauing. CONCLUSIONS: In this multicenter retrospective observational study patients with PerCI tended to have poorer short-term and long-term outcomes. However, the hazards of mortality plateaued beyond the first 10 days of ICU stay. Further studies should investigate predictors of developing PerCI, to better prognosticate long-term outcomes.en_US
dc.description.provenanceSubmitted by Gemma Siemensma (gemmas@bhs.org.au) on 2024-04-23T01:14:20Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma (gemmas@bhs.org.au) on 2024-06-14T12:14:03Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2024-06-14T12:14:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2024en
dc.titlePersistent critical illness and long-term outcomes in patients with COVID-19: A multicenter retrospective cohort study.en_US
dc.typeJournal Articleen_US
dc.type.specifiedArticleen_US
dc.bibliographicCitation.titleCritical Care Explorationsen_US
dc.bibliographicCitation.volume6en_US
dc.bibliographicCitation.issue3en_US
dc.bibliographicCitation.stpagee1057en_US
dc.subject.healththesaurusAUSTRALIA AND NEW ZEALAND INTENSIVE CARE SOCIETY ADULT PATIENT DATABASEen_US
dc.subject.healththesaurusCOVID-19en_US
dc.subject.healththesaurusPANDEMICen_US
dc.subject.healththesaurusPERSISTENT CRITICAL ILLNESSen_US
dc.identifier.doihttps://doi.org/10.1097/CCE.0000000000001057en_US
Appears in Collections:Research Output

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