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Medicina interna de México
versión impresa ISSN 0186-4866
Resumen
VASQUEZ-REVILLA, HR et al. Epidemiological characteristics of patients with chronic critical illness. Med. interna Méx. [online]. 2017, vol.33, n.2, pp.168-176. ISSN 0186-4866.
BACKGROUND:
Population of patients requiring intensive care for prolonged time has increased in recent decades resulting in a new population of patients with chronic critical illness (CCI).
OBJECTIVE:
To describe the epidemiologic characteristics of patients with chronic critical illness assisted at Regional Hospital of High Specialty of Oaxaca, Mexico.
MATERIAL AND METHOD:
A retrospective, prospective, observa tional and descriptive study included patients admitted from January 1st, 2012 to December 31st, 2015. Patients with CCI were defined as those with prolonged mechanical ventilation defined as ≥21 days of ventilation for ≥6 hours/day. Patients were followed until hospital discharge or death.
RESULTS:
284 patients were included; the incidence of CCI was 10%. In patients with CCI the APACHE II score was 19.4±9.7 and without CCI was 15.94±8.6 (p=0.044), while the SOFA scale in patients with CCI was 8.7±2.6 and without CCI 7.01±4.4 (p=0.007). Days of ICU stay were 17.1±9.2 for patients with CCI and 8±4.8 without CCI (p=0.0000). Days of hospital stay were 45.9±19.7 in patients with CCI and 18.3±12.4 in patients without CCI (p=0.0000). ICU mortality was 18% in patients with CCI and 28% in patients without CCI (p=0.0000). The hospital mortality was 50% in patients with CCI and 16% in patients without CCI (p=0.0000). Discharged from hospital were 32% of patients with CCI and 56% of patients without CCI (p=0.0000).
CONCLUSIONS:
The incidence of CCI in our study was similar to that reported in the literature. Severity of acute disease income according to APACHE and SOFA scales was related to the development of CCI. Patients with chronic critical illness had higher ICU stay, more days sedation, longer hospital stays and increased hospital mortality.
Palabras llave : chronic critical illness; intensive care units; prolonged mechanical ventilation.