Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study

BACKGROUND: To mitigate mortality among critically ill COVID-19 patients, both during their Intensive Care Unit (ICU) stay and following ICU discharge, it is crucial to measure its frequency, identify predictors and to establish an appropriate post-ICU follow-up strategy. METHODS: In this multicentr...

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Autores principales: Santos, Mariana M. S., Pereira, Isabel J., Cuboia, Nelson, Reis-Pardal, Joana, Adrião, Diana, Cardoso, Teresa, Aragão, Irene, Santos, Lurdes, Sarmento, António, Rosa, Regis G., Granja, Cristina, Teixeira, Cassiano, Azevedo, Luís
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621933/
https://www.ncbi.nlm.nih.gov/pubmed/37917761
http://dx.doi.org/10.1371/journal.pone.0293883
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author Santos, Mariana M. S.
Pereira, Isabel J.
Cuboia, Nelson
Reis-Pardal, Joana
Adrião, Diana
Cardoso, Teresa
Aragão, Irene
Santos, Lurdes
Sarmento, António
Rosa, Regis G.
Granja, Cristina
Teixeira, Cassiano
Azevedo, Luís
author_facet Santos, Mariana M. S.
Pereira, Isabel J.
Cuboia, Nelson
Reis-Pardal, Joana
Adrião, Diana
Cardoso, Teresa
Aragão, Irene
Santos, Lurdes
Sarmento, António
Rosa, Regis G.
Granja, Cristina
Teixeira, Cassiano
Azevedo, Luís
author_sort Santos, Mariana M. S.
collection PubMed
description BACKGROUND: To mitigate mortality among critically ill COVID-19 patients, both during their Intensive Care Unit (ICU) stay and following ICU discharge, it is crucial to measure its frequency, identify predictors and to establish an appropriate post-ICU follow-up strategy. METHODS: In this multicentre, prospective cohort study, we included 586 critically ill COVID-19 patients. RESULTS: We observed an overall ICU mortality of 20.1% [95%CI: 17.1% to 23.6%] (118/586) and an overall hospital mortality of 25.4% [95%CI: 22.1% to 29.1%] (149/586). For ICU survivors, 30 days (early) post-ICU mortality was 5.3% [95%CI: 3.6% to 7.8%] (25/468) and one-year (late) post-ICU mortality was 7.9% [95%CI: 5.8% to 10.8%] (37/468). Pre-existing conditions/comorbidities were identified as the main independent predictors of mortality after ICU discharge: hypertension and heart failure were independent predictors of early mortality; and hypertension, chronic kidney disease, chronic obstructive pulmonary disease and cancer were independent predictors of late mortality. CONCLUSION: Early and late post-ICU mortality exhibited an initial surge (in the first 30 days post-ICU) followed by a subsequent decline over time. Close monitoring of critically ill COVID-19 post-ICU survivors, especially those with pre-existing conditions, is crucial to prevent adverse outcomes, reduce mortality and to establish an appropriate follow-up strategy.
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spelling pubmed-106219332023-11-03 Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study Santos, Mariana M. S. Pereira, Isabel J. Cuboia, Nelson Reis-Pardal, Joana Adrião, Diana Cardoso, Teresa Aragão, Irene Santos, Lurdes Sarmento, António Rosa, Regis G. Granja, Cristina Teixeira, Cassiano Azevedo, Luís PLoS One Research Article BACKGROUND: To mitigate mortality among critically ill COVID-19 patients, both during their Intensive Care Unit (ICU) stay and following ICU discharge, it is crucial to measure its frequency, identify predictors and to establish an appropriate post-ICU follow-up strategy. METHODS: In this multicentre, prospective cohort study, we included 586 critically ill COVID-19 patients. RESULTS: We observed an overall ICU mortality of 20.1% [95%CI: 17.1% to 23.6%] (118/586) and an overall hospital mortality of 25.4% [95%CI: 22.1% to 29.1%] (149/586). For ICU survivors, 30 days (early) post-ICU mortality was 5.3% [95%CI: 3.6% to 7.8%] (25/468) and one-year (late) post-ICU mortality was 7.9% [95%CI: 5.8% to 10.8%] (37/468). Pre-existing conditions/comorbidities were identified as the main independent predictors of mortality after ICU discharge: hypertension and heart failure were independent predictors of early mortality; and hypertension, chronic kidney disease, chronic obstructive pulmonary disease and cancer were independent predictors of late mortality. CONCLUSION: Early and late post-ICU mortality exhibited an initial surge (in the first 30 days post-ICU) followed by a subsequent decline over time. Close monitoring of critically ill COVID-19 post-ICU survivors, especially those with pre-existing conditions, is crucial to prevent adverse outcomes, reduce mortality and to establish an appropriate follow-up strategy. Public Library of Science 2023-11-02 /pmc/articles/PMC10621933/ /pubmed/37917761 http://dx.doi.org/10.1371/journal.pone.0293883 Text en © 2023 Santos et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Santos, Mariana M. S.
Pereira, Isabel J.
Cuboia, Nelson
Reis-Pardal, Joana
Adrião, Diana
Cardoso, Teresa
Aragão, Irene
Santos, Lurdes
Sarmento, António
Rosa, Regis G.
Granja, Cristina
Teixeira, Cassiano
Azevedo, Luís
Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study
title Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study
title_full Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study
title_fullStr Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study
title_full_unstemmed Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study
title_short Predictors of early and long-term mortality after ICU discharge in critically ill COVID-19 patients: A prospective cohort study
title_sort predictors of early and long-term mortality after icu discharge in critically ill covid-19 patients: a prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10621933/
https://www.ncbi.nlm.nih.gov/pubmed/37917761
http://dx.doi.org/10.1371/journal.pone.0293883
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