McPeake, J. , Quasim, T. , Henderson, P., Leyland, A. H. , Lone, N. I., Walters, M. , Iwashyna, T. J. and Shaw, M. (2021) Multimorbidity and its relationship with long-term outcomes following critical care discharge: a prospective cohort study. Chest, 160(5), pp. 1681-1692. (doi: 10.1016/j.chest.2021.05.069) (PMID:34153342)
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Abstract
Background: Survivors of critical illness have poor long-term outcomes with subsequent increases in healthcare utilisation. Less is known about the interplay between multimorbidity and long-term outcomes. Research Question: How do baseline patient demographics impact mortality and healthcare utilisation in the year following discharge from critical care? Study design and methods: Using data from a prospectively collected cohort, we employed propensity score matching to assess differences in outcomes between patients with a critical care encounter and patients admitted to the hospital without critical care. Long-term mortality was examined via nationally linked data as was hospital resource use in the year following hospital discharge. The cause of death was also examined. Results: This analysis included 3112 participants. There was no difference in long-term mortality between the critical care and hospital cohorts (adjusted HR: 1.09 (95% CI: 0.90-1.32), p=0.39). Pre-hospitalisation emotional health issues such as a clinical diagnosis of depression, were associated with increased long-term mortality (HR:1.49 (95% CI: 1.14-1.96), p<0.004). Healthcare utilisation was different between the two cohorts in the year following discharge with the critical care cohort experiencing a 29% increased risk of hospital readmission (OR 1.29 (95% CI:1.11-1.50), p=0.001). Interpretation: This national cohort study has demonstrated increased resource use for critical care survivors in the year following discharge but fails to replicate past findings of increased longer-term mortality. Multimorbidity, lifestyle factors and socio-economic status appear influence long term outcomes and should be the focus of future research.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Henderson, Dr Philip and Quasim, Professor Tara and Walters, Professor Matthew and Shaw, Dr Martin and McPeake, Dr Jo and Leyland, Professor Alastair |
| Authors: | McPeake, J., Quasim, T., Henderson, P., Leyland, A. H., Lone, N. I., Walters, M., Iwashyna, T. J., and Shaw, M. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | Chest |
| Publisher: | Elsevier |
| ISSN: | 0012-3692 |
| ISSN (Online): | 1931-3543 |
| Published Online: | 18 June 2021 |
| Copyright Holders: | Copyright © 2021 The Authors |
| First Published: | First published in Chest 160(5): 1681-1692 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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