PMID- 36257472
OWN - NLM
STAT- MEDLINE
DCOM- 20230411
LR  - 20230426
IS  - 1931-3543 (Electronic)
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 163
IP  - 4
DP  - 2023 Apr
TI  - Days Spent at Home and Mortality After Critical Illness: A Cluster Analysis Using 
      Nationwide Data.
PG  - 826-842
LID - S0012-3692(22)03997-6 [pii]
LID - 10.1016/j.chest.2022.10.008 [doi]
AB  - BACKGROUND: Beyond the question of short-term survival, days spent at home could 
      be considered a patient-centered outcome in critical care trials. RESEARCH 
      QUESTION: What are the days spent at home and health care trajectories during the 
      year after surviving critical illness? STUDY DESIGN AND METHODS: Data were 
      extracted on adult survivors spending at least 2 nights in a French ICU during 
      2018 who were treated with invasive mechanical ventilation or vasopressors or 
      inotropes. Trauma, burn, organ transplant, stroke, and neurosurgical patients 
      were excluded. Stays at home, death, and hospitalizations were reported before 
      and after ICU stay, using state sequence analysis. An unsupervised clustering 
      method was performed to identify cohorts based on post-ICU trajectories. RESULTS: 
      Of 77,132 ICU survivors, 89% returned home. In the year after discharge, these 
      patients spent a median of 330 (interquartile range [IQR], 283-349) days at home. 
      At 1 year, 77% of patients were still at home and 17% had died. Fifty-one percent 
      had been re-hospitalized, and 10% required a further ICU admission. Forty-eight 
      percent used rehabilitation facilities, and 5.7%, hospital at home. Three 
      clusters of patients with distinct post-ICU trajectories were identified. 
      Patients in cluster 1 (68% of total) survived and spent most of the year at home 
      (338 [323-354] days). Patients in cluster 2 (18%) had more complex trajectories, 
      but most could return home (91%), spending 242 (174-277) days at home. Patients 
      in cluster 3 (14%) died, with only 37% returning home for 45 (15-90) days. 
      INTERPRETATION: Many patients had complex health care trajectories after 
      surviving critical illness. Wide variations in the ability to return home after 
      ICU discharge were observed between clusters, which represents an important 
      patient-centered outcome.
CI  - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Martin, Guillaume L
AU  - Martin GL
AD  - Caisse Nationale de l'Assurance Maladie, Paris, France.
FAU - Atramont, Alice
AU  - Atramont A
AD  - Caisse Nationale de l'Assurance Maladie, Paris, France.
FAU - Mazars, Marjorie
AU  - Mazars M
AD  - Caisse Nationale de l'Assurance Maladie, Paris, France.
FAU - Tajahmady, Ayden
AU  - Tajahmady A
AD  - Caisse Nationale de l'Assurance Maladie, Paris, France.
FAU - Agamaliyev, Emin
AU  - Agamaliyev E
AD  - Caisse Nationale de l'Assurance Maladie, Paris, France.
FAU - Singer, Mervyn
AU  - Singer M
AD  - Bloomsbury Institute for Intensive Care Medicine, Division of Medicine, 
      University College London, London, United Kingdom.
FAU - Leone, Marc
AU  - Leone M
AD  - Aix-Marseille University, Assistance Publique Hopitaux de Marseille, Department 
      of Anesthesia and Intensive Care Unit, Hospital Nord, Marseille, France; Societe 
      Francaise d'Anesthesie et de Reanimation (SFAR), Paris, France.
FAU - Legrand, Matthieu
AU  - Legrand M
AD  - Societe Francaise d'Anesthesie et de Reanimation (SFAR), Paris, France; 
      Department of Anesthesia and Perioperative Care, Division of Critical Care 
      Medicine, UCSF, San Francisco, CA; INI-CRCT network, Nancy, France. Electronic 
      address: matthieu.legrand@ucsf.edu.
LA  - eng
PT  - Journal Article
DEP - 20221017
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
SB  - IM
CIN - Chest. 2023 Apr;163(4):740-741. PMID: 37031977
MH  - Adult
MH  - Humans
MH  - *Critical Illness/therapy
MH  - Cluster Analysis
MH  - *Critical Care
MH  - Hospitalization
MH  - Hospitals
PMC - PMC10107061
OTO - NOTNLM
OT  - PICS
OT  - intensive care
OT  - outcome
OT  - trajectory
EDAT- 2022/10/19 06:00
MHDA- 2023/04/11 06:41
PMCR- 2022/10/17
CRDT- 2022/10/18 19:24
PHST- 2022/04/16 00:00 [received]
PHST- 2022/09/13 00:00 [revised]
PHST- 2022/10/05 00:00 [accepted]
PHST- 2023/04/11 06:41 [medline]
PHST- 2022/10/19 06:00 [pubmed]
PHST- 2022/10/18 19:24 [entrez]
PHST- 2022/10/17 00:00 [pmc-release]
AID - S0012-3692(22)03997-6 [pii]
AID - 10.1016/j.chest.2022.10.008 [doi]
PST - ppublish
SO  - Chest. 2023 Apr;163(4):826-842. doi: 10.1016/j.chest.2022.10.008. Epub 2022 Oct 
      17.