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    Changes in case-mix and outcomes of critically ill patients in an Australian tertiary intensive care unit

    152810_28158_Changes in case-mix.pdf (383.0Kb)
    Access Status
    Open access
    Authors
    Williams, Teresa
    Ho, K.
    Dobb, G.
    Finn, J.
    Knuiman, M.
    Webb, S.
    Date
    2010
    Type
    Journal Article
    
    Metadata
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    Citation
    Williams, T.A. and Ho, K.M. and Dobb, G.J. and Finn, J.C. and Knuiman, M.W. and Webb, S.A.R. 2010. Changes in case-mix and outcomes of critically ill patients in an Australian tertiary intensive care unit. Anaesthesia and Intensive Care. 38 (4): pp. 703-709.
    Source Title
    Anaesthesia and Intensive Care
    ISSN
    0310057X
    School
    School of Nursing and Midwifery
    Remarks

    The Anaesthesia and Intensive Care journal can be located at http://www.aaic.net.au

    URI
    http://hdl.handle.net/20.500.11937/40226
    Collection
    • Curtin Research Publications
    Abstract

    Critical care service is expensive and the demand for such service is increasing in many developed countries. This study aimed to assess the changes in characteristics of critically ill patients and their effect on long-term outcome. This cohort study utilised linked data between the intensive care unit database and state-wide morbidity and mortality databases. Logistic and Cox regression was used to examine hospital survival and five-year survival of 22,298 intensive care patients, respectively. There was a significant increase in age, severity of illness and Charlson Comorbidity Index of the partients over a 16-year study period. Although hospital mortality and median length of intensive care unit and hospital stay remained unchanged, one- and five-year survival had significantly improved with time, after adjusting the age, gender, severity of illness, organ failure, comorbidity, 'new' cancer and diagnostic group. Stratified analyses showed that the improvement of five-year survival was particularly strong among patients admitted after cardiac surgery (P=0.001). In conclusion, although critical care service is increasingly being provided to patients with a higher severity of acute and chronic illnesses, long-term survical outcome has improved with time suggesting that critical care service may still be cost-effectiveness despite the changes in case-mix.

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