The Effect of Age on Length of Stay in the Medical Intensive Care Unit

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 225A
Author(s):  
Edison G. Gavilanes ◽  
Nycholle L. Gavilanes ◽  
Robert Fleming
Author(s):  
Akshay Dafal ◽  
Sunil Kumar ◽  
Sachin Agrawal ◽  
Sourya Acharya ◽  
Apoorva Nirmal

Abstract Introduction Anion gap (AG) metabolic acidosis is common in critically ill patients. The relationship between initial AG at the time of admission to the medical intensive care unit (MICU) and mortality or length of stay is unclear. This study was undertaken to evaluate this relationship. Materials and Method We prospectively examined the acid–base status of 500 consecutive patients at the time of MICU admission and outcome was measured in terms of mortality, length of ICU stay, need of ventilator, and laboratory parameters. The patients were divided into four stages based on the severity of AG. Outcome based on the severity of AG was measured, and comparisons that adjusted for baseline characteristics were performed. Results This study showed that increased AG was associated with the higher mortality. Patients with the highest AG also had the longest length of stay in the MICU, and patients with normal acid–base status had the shortest ICU length of stays (p < 0.05). Conclusion A high AG at the time of admission to the MICU was associated with higher mortality and length of stays. Initial risk stratification based on AG and metabolic acidosis may help guide appropriate patient disposition (especially in patients without other definitive criteria for MICU admission) and assist with prognosis.


2007 ◽  
Vol 35 (6) ◽  
pp. 1530-1535 ◽  
Author(s):  
Sally A. Norton ◽  
Laura A. Hogan ◽  
Robert G. Holloway ◽  
Helena Temkin-Greener ◽  
Marcia J. Buckley ◽  
...  

1996 ◽  
Author(s):  
Curtis P. Langlotz ◽  
Harold L. Kundel ◽  
Inna Brikman ◽  
Hugh M. Pratt ◽  
Regina O. Redfern ◽  
...  

1996 ◽  
Vol 12 (1) ◽  
pp. 12-15
Author(s):  
Margie B Zak ◽  
Carl F Dmuchowski ◽  
Maureen A Smythe

Objective: The goals of this article are to (1) identify the incidence of reported laboratory abnormalities in patients in the medical intensive care unit (ICU); (2) characterize the relationship between reported laboratory abnormalities and Acute Physiology and Chronic Health Evaluation III (APACHE III) score, length of stay, and mortality; and (3) evaluate therapeutic replacement in patients with electrolyte abnormalities. Design: Retrospective chart review of all patients admitted to the medical ICU between April 1, 1993 and June 30, 1993. Setting: Large teaching institution. Participants: Patients admitted to the medical ICU (n = 116). Interventions: The following data were collected: age, sex, admitting diagnosis, serum electrolyte and laboratory parameters, APACHE HI score, length of ICU stay, and mortality. Results: Ten individual laboratory abnormalities were found in more than 30% of all patients in the medical ICU (range 32.8–59.5%). Abnormalities in four laboratory parameters were associated with undesirable patient outcomes. Patients with hypoalbuminemia had a significantly higher APACHE HI score (p < 0.05). Hypocalcemia, hypomagnesemia, and hypoalbuminemia all were associated with an increased length of stay in the ICU (p < 0.05). Overall mortality was significantly higher in patients with alkalosis (p = 0.002). Therapeutic replacement in those with low electrolyte concentrations often was delayed or missed. Fifteen to 75% of patients who had abnormally low serum electrolyte concentrations were not treated. Conclusions: A high incidence of laboratory abnormalities is reported in patients admitted to the medical ICU. Several of these abnormalities are associated with undesirable outcomes such as an increased length of ICU stay in patients with hypoalbuminemia, hypocalcemia, and hypomagnesemia and increased mortality in patients with alkalosis. Therapeutic replacement of electrolytes in patients with abnormalities often was delayed or missed.


2020 ◽  
Vol 11 ◽  
pp. 215013272095468
Author(s):  
Kiran Ali ◽  
Sanjana Rao ◽  
Gilbert Berdine ◽  
Victor Test ◽  
Kenneth Nugent

Background: COVID-19 is a highly infectious disease which usually presents with respiratory symptoms. This virus is disseminated through respiratory droplets, and, therefore, individuals residing in close quarters are at a higher risk for the acquisition of infection. The prison population is at a significantly increased risk for infection. Methods: Prisoners from the Montford Correctional facility in Lubbock, Texas, hospitalized in the medical intensive care unit at University Medical Center between March 1, 2020 and May 15, 2020 were compared to community-based patients hospitalized in the same medical intensive care unit. Clinical information, laboratory results, radiographic results, management requirements, and outcomes were compared. Results: A total of 15 community-based patients with a mean age of 67.4 ± 15.5 years were compared to 5 prisoners with a mean age of 56.0 ± 9.0 years. All prisoners were men; 10 community-based patients were men. Prisoners presented with fever, dyspnea, and GI symptoms. The mean number of comorbidities in prisoners was 2.4 compared to 1.8 in community-based patients. Prisoners had significantly lower heart rates and respiratory rates at presentation than community-based patients. The mean length of stay in prisoners was 12.6 ± 8.9 days; the mean length of stay in community-based patients was 8.6 ± 6.5. The case fatality rate was 60% in both groups. Conclusions: Prisoners were younger than community-based patients but required longer lengths of stay and had the same mortality rate. This study provides a basis for comparisons with future studies which could involve new treatment options currently under study.


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