Baseline degree of dependency in basic and instrumental activities of daily living as a predictor of survival of patients discharged from the Intensive Care Unit of a public hospital in the city of Santiago, Chile over a period of 5 years.
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Abstract
Objective: to analyze whether the baseline functional status of patients hospitalized in the intensive care unit (ICU) of the San Juan de Dios Hospital (HSJD) in Santiago, Chile, has an association with survival time after discharge from the unit.
Design: prognosis study: cohort.
Setting: high complexity public hospital, ICU. Study period: 2013 – 2017. Follow-up period until 2018.
Patients: consecutive sample selection process: over 15 years of age who were discharged alive from the HSJD ICU of Santiago between January 1, 2013 and December 31, 2017. Number of eligible subjects: 1445. Number of participating subjects: 1254 for Katz scale and 1143 for Lawton index, loss of 13.2% and 20.9% respectively.
Interventions: survival follow-up until December 31, 2018.
Main variables of interest: analysis of post-ICU survival and relationship with functional dependency indicators.
Results: post-ICU mortality of 39.4%. Survival rate at 30 days: 90.7%, at 180 days: 77.8%, at 3 years 60%, at 5 years 54.3%, with the factors that are independently associated with a higher risk of mortality: age, classification of admission priority 3, moderate dependence (HR 1.79 95% CI [1.08-2.97]) and severe (HR 2.36 95% CI [1.62-3.43]) according to Katz and severe dependence according to Lawton (HR 1.71 95%CI [1.23-2.60]).
Conclusions: the greater the degree of baseline dependence in patients discharged from the ICU, the greater the probability of death. The survival rate was higher in the group of patients classified as independent for both Katz and Lawton.
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