Outcome and Cost of Prolonged Stay in the Surgical Intensive Care Unit

Abstract

• We retrospectively studied 50 surgical patients who required more than 14 days of care in the intensive care unit (ICU) in terms of the admission diagnosis, reason for extended stay, complications, cost, therapeutic intervention scores, mortality, and quality of life after discharge. The morbidity, mortality, and cost were extraordinary. Survival varied inversely with the therapeutic intervention scores. The ICU and one-year mortalities were 46.0% and 74.5%, respectively. The quality of life following discharge was generally poor. Increased mortality was associated with the following criteria: multiple-organ failure, age, sepsis, cancer, the combination of infection and failure of a major organ system, the requirement for a tracheostomy for prolonged respiratory support, and the requirement for hemodialysis for renal failure. In light of the escalating demand and cost of ICU care, it is advisable to identify those factors that determine whether these patients will benefit from intensive care, to develop strategies that are cognizant of the prognosis and the cost at the outset of care. (Arch Surg 1984;119:1338-1342)