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The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study

BACKGROUND: Patients with critical illness have a high risk of mortality. Key decision-making in the health system affecting the outcomes of critically ill patients requires epidemiological evidence, but the burden of critical illness is largely unknown. This study aimed to estimate the prevalence o...

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Autores principales: Schell, Carl Otto, Wellhagen, Andreas, Lipcsey, Miklós, Kurland, Lisa, Bjurling-Sjöberg, Petronella, Stålsby Lundborg, Cecilia, Castegren, Markus, Baker, Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483802/
https://www.ncbi.nlm.nih.gov/pubmed/37679836
http://dx.doi.org/10.1186/s40001-023-01279-0
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author Schell, Carl Otto
Wellhagen, Andreas
Lipcsey, Miklós
Kurland, Lisa
Bjurling-Sjöberg, Petronella
Stålsby Lundborg, Cecilia
Castegren, Markus
Baker, Tim
author_facet Schell, Carl Otto
Wellhagen, Andreas
Lipcsey, Miklós
Kurland, Lisa
Bjurling-Sjöberg, Petronella
Stålsby Lundborg, Cecilia
Castegren, Markus
Baker, Tim
author_sort Schell, Carl Otto
collection PubMed
description BACKGROUND: Patients with critical illness have a high risk of mortality. Key decision-making in the health system affecting the outcomes of critically ill patients requires epidemiological evidence, but the burden of critical illness is largely unknown. This study aimed to estimate the prevalence of critical illness in a Swedish region. Secondary objectives were to estimate the proportion of hospital inpatients who are critically ill and to describe the in-hospital location of critically ill patients. METHODS: A prospective, multi-center, population-based, point-prevalence study on specific days in 2017–2018. All adult (> 18 years) in-patients, regardless of admitting specially, in all acute hospitals in Sörmland, and the patients from Sörmland who had been referred to university hospitals, were included. Patients in the operating theatres, with a psychiatric cause of admission, women in active labor and moribund patients, were excluded. All participants were examined by trained data collectors. Critical illness was defined as “a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided and a potential for reversibility”. The presence of one or more severely deranged vital signs was used to classify critical illness. The prevalence of critical illness was calculated as the number of critically ill patients divided by the number of adults in the region. RESULTS: A total of 1269 patients were included in the study. Median age was 74 years and 50% of patients were female. Critical illness was present in 133 patients, resulting in an adult population prevalence of critical illness per 100,000 people of 19.4 (95% CI 16.4–23.0). The proportion of patients in hospital who were critically ill was 10.5% (95% CI 8.8–12.3%). Among the critically ill, 125 [95% CI 94.0% (88.4–97.0%)] were cared for in general wards. CONCLUSIONS: The prevalence of critical illness was higher than previous, indirect estimates. One in ten hospitalized patients were critically ill, the large majority of which were cared for in general wards. This suggests a hidden burden of critical illness of potential public health, health system and hospital management significance. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40001-023-01279-0.
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spelling pubmed-104838022023-09-08 The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study Schell, Carl Otto Wellhagen, Andreas Lipcsey, Miklós Kurland, Lisa Bjurling-Sjöberg, Petronella Stålsby Lundborg, Cecilia Castegren, Markus Baker, Tim Eur J Med Res Research BACKGROUND: Patients with critical illness have a high risk of mortality. Key decision-making in the health system affecting the outcomes of critically ill patients requires epidemiological evidence, but the burden of critical illness is largely unknown. This study aimed to estimate the prevalence of critical illness in a Swedish region. Secondary objectives were to estimate the proportion of hospital inpatients who are critically ill and to describe the in-hospital location of critically ill patients. METHODS: A prospective, multi-center, population-based, point-prevalence study on specific days in 2017–2018. All adult (> 18 years) in-patients, regardless of admitting specially, in all acute hospitals in Sörmland, and the patients from Sörmland who had been referred to university hospitals, were included. Patients in the operating theatres, with a psychiatric cause of admission, women in active labor and moribund patients, were excluded. All participants were examined by trained data collectors. Critical illness was defined as “a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided and a potential for reversibility”. The presence of one or more severely deranged vital signs was used to classify critical illness. The prevalence of critical illness was calculated as the number of critically ill patients divided by the number of adults in the region. RESULTS: A total of 1269 patients were included in the study. Median age was 74 years and 50% of patients were female. Critical illness was present in 133 patients, resulting in an adult population prevalence of critical illness per 100,000 people of 19.4 (95% CI 16.4–23.0). The proportion of patients in hospital who were critically ill was 10.5% (95% CI 8.8–12.3%). Among the critically ill, 125 [95% CI 94.0% (88.4–97.0%)] were cared for in general wards. CONCLUSIONS: The prevalence of critical illness was higher than previous, indirect estimates. One in ten hospitalized patients were critically ill, the large majority of which were cared for in general wards. This suggests a hidden burden of critical illness of potential public health, health system and hospital management significance. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40001-023-01279-0. BioMed Central 2023-09-07 /pmc/articles/PMC10483802/ /pubmed/37679836 http://dx.doi.org/10.1186/s40001-023-01279-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Schell, Carl Otto
Wellhagen, Andreas
Lipcsey, Miklós
Kurland, Lisa
Bjurling-Sjöberg, Petronella
Stålsby Lundborg, Cecilia
Castegren, Markus
Baker, Tim
The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study
title The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study
title_full The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study
title_fullStr The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study
title_full_unstemmed The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study
title_short The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study
title_sort burden of critical illness among adults in a swedish region—a population-based point-prevalence study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483802/
https://www.ncbi.nlm.nih.gov/pubmed/37679836
http://dx.doi.org/10.1186/s40001-023-01279-0
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