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International Journal of
Anesthetics and Anesthesiology ISSN: 2377-4630

Citation

Tollisen K, Bjerva M, Dahl GT, Meidell NK, Sandvik L, et al. (2019) Acute illness, Comorbidity and Mortality in a Norwegian Intensive Care Population. Int J Anesthetic Anesthesiol 6:084. doi.org/10.23937/2377-4630/1410084

Copyright

© 2019 Tollisen K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ORIGINAL ARTICLE | OPEN ACCESS DOI: 10.23937/2377-4630/1410084

Acute illness, Comorbidity and Mortality in a Norwegian Intensive Care Population

K Tollisen1,2*, M Bjerva3, GT Dahl4, NK Meidell3, L Sandvik5, F Heyerdahl3 and D Jacobsen1,2

1Institute of Clinical Medicine, University of Oslo, Norway

2Department of Acute Medicine, Oslo University Hospital, Norway

3Department of Anesthesiology, Oslo University Hospital, Norway

4Department of Anesthesiology, Diakonhjemmet Hospital, Norway

5Oslo Centre for Biostatistics and Epidemiology, Norway

Abstract

Background

The need for intensive care beds is high and expected to increase. Descriptive studies of the intensive care population may reveal differences in predisposing factors and outcome within subgroups and help identify areas in need of increased prevention efforts.

Objective

To describe preadmission and clinical characteristics of an intensive care population in Oslo, and to compare the characteristics and outcomes of selected subgroups of this ICU-population.

Method

Prospective observational cohort study of intensive care patients aged ≥ 18, admitted to two hospitals in Oslo during a one-year period. Acute illness characteristics, comorbidity, limitations of life-sustaining treatment and hospital mortality were studied for the overall population and stratified for a) Gender and b) Medical and surgical patients within the age groups 18-59 years and 60 and above.

Results

We included 861 patients, 567 (66%) males; median age 63 years (range 18-95); 537 (62%) medical admissions and 324 (38%) surgical admissions. 632 (73%) received mechanical ventilation. Trauma (n = 191, 21%) and cardiovascular disease (n = 180, 20%) were the most common causes of admission. In patients aged 18-59, poisoning caused 56/217 (26%) of the medical admissions and medical patients had a higher prevalence of pre-existing chronic disease (157/217, 72% vs. 69/160, 43%) and Charlson comorbidity index (mean 2.0 vs. 0.7, p < 0.001) than surgical patients. In patients aged 60 and above, comorbidity was similar, but medical patients had a higher hospital mortality (143/320, 45% vs. 58/164, 34%, p < 0.05). 205 (24%) died in the ICU, and limitations of life-sustaining treatment were made in 183 (89%) cases 279(32%) died during the hospital stay. Of the 582 surviving patients 455 (78%) were discharged to home or rehabilitation, 88 (15%) to nursing homes and 39 (7%) to other institutions.

Conclusion

In patients younger than 60 years, trauma and poisoning were the most common causes of admission. Within this age group, medical patients had much higher prevalence of preexisting chronic disease than surgical patients, suggesting differences in predisposing factors. The majority of the surviving patients were discharged to home or to rehabilitation, indicating a low prevalence of futile intensive care.