0
Original Research |

Epidemiology of Critical Care Syndromes, Organ Failures, and Life-Support Interventions in a Suburban US CommunityEpidemiology of Critical Care Syndromes

Rodrigo Cartin-Ceba, MD; Marija Kojicic, MD; Guangxi Li, MD; Daryl J. Kor, MD; Jaise Poulose, MD; Vitaly Herasevich, MD; Rahul Kashyap, MBBS, MD; Cesar Trillo-Alvarez, MD; Javier Cabello-Garza, MD; Rolf Hubmayr, MD, FCCP; Edward G. Seferian, MD; Ognjen Gajic, MD
Author and Funding Information

From the Multidisciplinary Epidemiology and Translational Research in Intensive Care (M.E.T.R.I.C) (Drs Cartin-Ceba, Kojicic, Li, Kor, Poulose, Herasevich, Kashyap, Trillo-Alvarez, Cabello-Garza, Hubmayr, Seferian, and Gajic); Department of Medicine (Drs Cartin-Ceba, Li, Poulose, Herasevich, Trillo-Alvarez, Cabello-Garza, Hubmayr, Seferian, and Gajic), Division of Pulmonary and Critical Care Medicine; and Department of Anesthesiology (Dr Kor), Mayo Clinic, Rochester, MN; and Institute for Pulmonary Diseases of Vojvodina (Dr Kojicic), Sremska Kamenica, Serbia.Dr Seferian is currently at Cedars-Sinai Medical Center (Los Angeles, California).

Correspondence to: Rodrigo Cartin-Ceba, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905; e-mail: cartinceba.rodrigo@mayo.edu

Data are presented as mean ± SD, No. (%), and median (interquartile range). APACHE = Acute Physiologic and Chronic Health Evaluation; DNR = do not resuscitate; PACU = postanesthesia care unit.

AKI = acute kidney injury; ALI = acute lung injury; CCS = critical care syndrome; DIC = disseminated intravascular coagulation; IABP = intraaortic balloon counterpulsation; LVAD = left ventricular assist device; MV = mechanical ventilation; RRT = renal replacement therapy.

a

Per 100,000 population.

b

According to the Sequential Organ Failure Assessment.

See Table 2 legend for expansion of abbreviation.

Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


Chest. 2011;140(6):1447-1455. doi:10.1378/chest.11-1197
Text Size: A A A
Published online

Background:  ICU services represent a significant and increasing proportion of medical care. Population-based epidemiologic studies are essential to inform physicians and policymakers about current and future ICU demands. We aimed to determine the incidence of critical care syndromes, organ failures, and life-support interventions in a defined US suburban community with unrestricted access to critical care services.

Methods:  This population-based observational cohort from January 1 to December 31, 2006, in Olmsted County, Minnesota, included all consecutive critically ill adult residents admitted to the ICU. Main outcomes were incidence of critical care syndromes, life-support interventions, and organ failures as defined by standard criteria. Incidences are reported per 100,000 population (95% CIs) and were age adjusted to the 2006 US population.

Results:  A total of 1,707 ICU admissions were identified from 1,461 patients. Incidences of critical care syndromes were respiratory failure, 430 (390-470); acute kidney injury, 290 (257-323); severe sepsis, 286 (253-319); all-cause shock, 194 (167-221); acute lung injury, 86 (68-105); all-cause coma, 43 (30-55); and overt disseminated intravascular coagulation, 18 (10-26). Incidence of mechanical ventilation was invasive, 310 (276-344); noninvasive, 180 (154-206); vasopressors and inotropes, 183(155-208). Renal replacement therapy incidence was 96 (77-116). Of the cohort, 1,330 patients (91%) survived to hospital discharge. Short- and long-term survival decreased by the number of failing organs.

Conclusions:  In a suburban US community with high access to critical care services, cumulative incidences of critical care syndromes and life-support interventions were higher than previously reported. The results of this study have important implications for future planning of critical care delivery.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
Guidelines
Critical care in pregnancy.
American College of Obstetricians and Gynecologists | 7/10/2009
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543