Two-year outcome of adult intensive care patients.

Five hundred fifty-eight patients admitted to a general/medical surgical intensive care unit were studied 2 years after hospital discharge to determine whether they were still alive, were able to perform daily activities, and had returned to work. The overall 2-year survivorship (hospital and long-term) was 63.5%. Two-year survival was considerably lower for patients with certain condition or treatment characteristics than for others. This ranged from 14% 2-year survival for patients with 48 or more hours of coma to 82.2% for patients with no condition or treatment characteristics recorded. Once a patient was discharged alive, the 2-year cumulative survival of surgical ICU patients (84.6%) was significantly better than that of medical ICU patients (76.5%). Among ICU survivors responding to a follow-up survey, 85% were able to perform daily activities, but only 66% were working. Of the 44 patients experiencing a change in ability to perform daily activities at time of follow-up compared with pre-ICU admission, functional status of 34 (77%) improved, while 10 (23%) got worse. By comparison, of the 45 patients experiencing a change in working status, only 7 patients (16%) who did not work prior to ICU admission had returned to work, whereas the remaining 38 patients (84%) who worked prior to ICU admission were not working at time of follow-up study.

Hospital charges and long-term survival of ICU versus non-ICU patients.

Hospital charges and long-term (2 yr) survival were evaluated for 558 ICU and 124 non-ICU patients from a large community hospital. Although the ICU patients represented only 9.5% of total hospital admissions, they incurred nearly 30% of the total hospital charges and had a median hospital charge of greater than four times the non-ICU comparison group. For the ICU patients, the overall in-hospital mortality rate was 17.3% and the overall 2-yr mortality rate was 35.6%, whereas the non-ICU group rates were 3.4 and 14.8% respectively. Given a patient was discharged alive from the hospital, the proportion surviving an additional 2 yr was strikingly similar for the two groups (83.3% of ICU patients and 89.1% of non-ICU patients). Because of excess mortality for ICU patients, discharged from a community hospital was not significantly greater than for non-ICU patients, the long-term outlook for discharged patients after receiving intensive care is not as bleak as is generally assumed.