Survivors of critical illness have poor long-term outcomes with subsequent increases in healthcare utilisation. Less is known about the interplay between multimorbidity and long-term outcomes.
How do baseline patient demographics impact mortality and healthcare utilisation in the year following discharge from critical care?
Using data from a prospectively collected cohort, we employed propensity score matching to assess differences in outcomes between patients with a critical care encounter and patients admitted to the hospital without critical care. Long-term mortality was examined via nationally linked data as was hospital resource use in the year following hospital discharge. The cause of death was also examined.
This analysis included 3112 participants. There was no difference in long-term mortality between the critical care and hospital cohorts (adjusted HR: 1.09 (95% CI: 0.90-1.32), p=0.39). Pre-hospitalisation emotional health issues such as a clinical diagnosis of depression, were associated with increased long-term mortality (HR:1.49 (95% CI: 1.14-1.96), p<0.004). Healthcare utilisation was different between the two cohorts in the year following discharge with the critical care cohort experiencing a 29% increased risk of hospital readmission (OR 1.29 (95% CI:1.11-1.50), p=0.001).
This national cohort study has demonstrated increased resource use for critical care survivors in the year following discharge but fails to replicate past findings of increased longer-term mortality. Multimorbidity, lifestyle factors and socio-economic status appear influence long term outcomes and should be the focus of future research.

Copyright © 2021. Published by Elsevier Inc.

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