Death in hospital following ICU discharge: insights from the LUNG SAFE study

Fabiana Madotto , Bairbre Mcnicholas , Emanuele Rezoagli , Tài Pham , John Laffey , Giacomo Bellani , Antonio Pesenti , John Laffey , Laurent Brochard , Andres Esteban , Luciano Gattinoni , Frank van Haren , Marco Ranieri , Gordon Rubenfeld , Gordon Rubenfeld , B. Taylor Thompson , Arthur Slutsky , Fernando Rios , Frank van Haren , Mohammad Omar Faruq , T. Sottiaux , P. Depuydt , Fredy Lora , Cesar Cesar Azevedo , Eddy Fan , Guillermo Bugedo , Haibo Qiu , Marcos Gonzalez , Juan Silesky , Vladimir Cerny , Jonas Nielsen , Manuel Jibaja , Tài Pham , Hermann Wrigge , Dimitrios Matamis , Jorge Luis Ranero , Charles Gomersall , Pravin Amin , S. Hashemian , Kevin Clarkson , Giacomo Bellani , Kiyoyasu Kurahashi , Younsuck Koh , Asisclo Villagomez , Amine Ali Zeggwagh , Leo Heunks , Jon Henrik Laake , Waqar Kashif , Jorge Synclair , Jose Emmanuel Palo , Antero Do Vale Fernandes , Dorel Sandesc , Yaasen Arabi , Vesna Bumbasierevic , Nicolas Nin , Jose Lorente , Anders Larsson , Lise Piquilloud , Boonsong Patjanasoontorn , Fekri Abroug , Daniel Mcauley , Lia Mcnamee , Javier Hurtado , Ed Bajwa , Gabriel Démpaire , Guy Francois , Francesca Rabboni , Fabiana Madotto , Sara Conti , Hektor Sula , Lordian Nunci , Alma Cani , Alan Zazu , Christian Dellera , Carolina Insaurralde , Risso Alejandro , Julio Daldin , Mauricio Vinzio , Ruben Fernandez , Luis Cardonnet , Lisandro Bettini , Mariano Carboni Bisso , Emilio Osman , Mariano Setten , Pablo Lovazzano , Javier Alvarez , Veronica Villar , Norberto Pozo , Nicolas Grubissich , Gustavo Plotnikow , Daniela Vasquez , Santiago Ilutovich , Norberto Tiribelli , Ariel Chena , Carlos Pellegrini , María Saenz , Elisa Estenssoro , Matias Brizuela , Hernan Gianinetto , Pablo Gomez , Valeria Cerrato , Marco Bezzi , Silvina Borello , Flavia Loiacono , Adriana Fernandez , Serena Knowles , Claire Reynolds , Deborah Inskip , Jennene Miller , Jing Kong , Christina Whitehead , Shailesh Bihari , Aylin Seven , Amanda Krstevski , Helen Rodgers , Rebecca Millar , Toni Mckenna , Irene Bailey , Gabrielle Hanlon , Anders Aneman , Joan Lynch , Raman Azad , John Neal , Paul Woods , Brigit Roberts , Mark Kol , Helen Wong , Katharina Riss , Thomas Staudinger , Xavier Wittebole , Caroline Berghe , Pierre Bulpa , Alain Dive , Rik Verstraete , Herve Lebbinck , Pieter Depuydt , Joris Vermassen , Philippe Meersseman , Helga Ceunen , Jonas Rosa , Daniel Beraldo , Claudio Piras , Adenilton Rampinelli , Ñ Nassar , Sergio Mataloun , Marcelo Moock , Marlus Thompson , Claudio Gonçalves , Ana Carolina P. 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, Jon Laake , Andreas Barratt-Due , Kim Andre L. 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Artiga , Oscar Penuelas , Tomas Roser , Moreno Olga , Elena Gallego Curto , Rocío Manzano Sánchez , Vallverdu Imma , Garcia Elisabet , Laura Claverias , Monica Magret , Ana Pellicer , Lucia Rodriguez , Jesús Sánchez-Ballesteros , Ángela González-Salamanca , Antonio Jimenez , Francisco Huerta , Juan Carlos J. Sotillo Diaz , Esther Bermejo Lopez , David Moya , Alec Alfonso , Palazon Sanchez Eugenio Luis , Palazon Sanchez Cesar , Sánchez Rafael , Corcoles Virgilio , Noelia Recio , Richard Adamsson , Christian Rylander , Bernhard Holzgraefe , Lars Broman , Joanna Wessbergh , Linnea Persson , Fredrik Schiöler , Hans Kedelv , Anna Oscarsson Tibblin , Henrik Appelberg , Lars Hedlund , Johan Helleberg , Karin Eriksson , Rita Glietsch , Niklas Larsson , Ingela Nygren , Silvia Nunes , Anna-Karin Morin , Thomas Kander , Anne Adolfsson , Lise Piquilloud , Hervé Zender , Corinne Leemann-Refondini , Souheil Elatrous , Slaheddine Bouchoucha , Imed Chouchene , Islem Ouanes , La Marsa , Asma Ben Souissi , Salma Kamoun , Oktay Demirkiran , Mustafa Aker , Emre Erbabacan , Ilkay Ceylan , Nermin Kelebek Girgin , Menekse Ozcelik , Necmettin Ünal , Basak Ceyda Meco , Onat Akyol , Suleyman Derman , Barry Kennedy , Ken Parhar , Latha Srinivasa , Lia Mcnamee , Danny Mcauley , Phil Hopkins , Clare Mellis , Vivek Kakar , Dan Hadfield , Andre Vercueil , Kaushik Bhowmick , Sally Humphreys , Andrew Ferguson , Raymond Mckee , Ashok Raj , Danielle Fawkes , Philip Watt , Linda Twohey , Rajeev Thomas , Alex Morton , Varsha Kadaba , Mark Smith , Anil Hormis , Santhana Kannan , Miriam Namih , Henrik Reschreiter , Julie Camsooksai , Alek Kumar , Szabolcs Rugonfalvi , Christopher Nutt , Orla Oneill , Colette Seasman , Ged Dempsey , Christopher Scott , Helen Ellis , Stuart Mckechnie , Paula Hutton , Nora Di Tomasso , Michela Vitale , Ruth Griffin , Michael Dean , Julius Cranshaw , Emma Willett , Nicholas Ioannou , Sarah Gillis , Peter Csabi , Rosaleen Macfadyen , Heidi Dawson , Pieter Preez , Alexandra Williams , Owen Boyd , Laura Ortiz-Ruiz de Gordoa , Jon Bramall , Sophie Symmonds , Simon Chau , Tim Wenham , Tamas Szakmany , Piroska Toth-Tarsoly , Katie Mccalman , Peter Alexander , Lorraine Stephenson , Thomas Collyer , Rhiannon Chapman , Raphael Cooper , Russell Allan , Malcolm Sim , David Wrathall , Donald Irvine , Kim Zantua , John Adams , Andrew Burtenshaw , Gareth Sellors , Ingeborg Welters , Karen Williams , Robert Hessell , Matthew Oldroyd , Ceri Battle , Suresh Pillai , Istvan Kajtor , Mageswaran Sivashanmugavel , Sinead Okane , Adrian Donnelly , Aniko Frigyik , Jon Careless , Martin May , Richard Stewart , T. John Trinder , Samantha Hagan , Matt Wise , Jade Cole , Caroline Macfie , Anna Dowling , Javier Hurtado , Nicolás Nin , Javier Hurtado , Edgardo Nuñez , Gustavo Pittini , Ruben Rodriguez , María Imperio , Cristina Santos , Alberto Deicas , Carolina Serra , Aditya Uppalapati , Ghassan Kamel , Valerie Banner-Goodspeed , Jeremy Beitler , Satyanarayana Reddy Mukkera , Shreedhar Kulkarni , Jarone Lee , Tomaz Mesar , John Shinn Iii , Dina Gomaa , Christopher Tainter , Jarone Lee , Tomaz Mesar , Jarone Lee , Dale Yeatts , Jessica Warren , Michael Lanspa , Russel Miller , Colin Grissom , Samuel Brown , Philippe Bauer , Ryan Gosselin , Barrett Kitch , Jason Cohen , Scott Beegle , Renaud Gueret , Aiman Tulaimat , Shazia Choudry , William Stigler , Hitesh Batra , Nidhi Huff , Keith Lamb , Trevor Oetting , Nicholas Mohr , Claine Judy , Shigeki Saito , Fayez Kheir , Fayez Kheir , Adam Schlichting , Angela Delsing , Daniel Crouch , Mary Elmasri , Daniel Crouch , Dina Ismail , Kyle Dreyer , Thomas Blakeman , Kyle Dreyer , Dina Gomaa , Rebecca Baron , Carolina Quintana Grijalba , Peter Hou , Raghu Seethala , Imo Aisiku , Galen Henderson , Gyorgy Frendl , Sen-Kuang Hou , Robert Owens , Ashley Schomer , Vesna Bumbasirevic , Bojan Jovanovic , Maja Surbatovic , Milic Veljovic , John Laffey , Giacomo Bellani , Antonio Pesenti

1 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases

Abstract Background To determine the frequency of, and factors associated with, death in hospital following ICU discharge to the ward. Methods The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU stay. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations. Results 2186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge. Conclusions A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors. Trial Registration : ClinicalTrials.gov NCT02010073 .

Domaines: Sciences du Vivant [q-bio]

Fabiana Madotto, Bairbre Mcnicholas, Emanuele Rezoagli, Tài Pham, John Laffey, et al.. Death in hospital following ICU discharge: insights from the LUNG SAFE study. Critical Care, 2021, 25 (1), pp.144. ⟨10.1186/s13054-021-03465-0⟩. ⟨hal-03997442⟩