TY - JOUR
T1 - Outcomes 30 days after ICU admission
T2 - The 30DOS study
AU - Wise, Robert
AU - de Vasconcellos, Kim
AU - Skinner, David
AU - Rodseth, Reitze
AU - Gopalan, Dean
AU - Muckart, David
AU - Banoo, Zohra
AU - Bisseru, Tashmin
AU - Blakemore, Steve
AU - de Meyer, Jenine
AU - Faurie, Michael
AU - Govender, Kom
AU - Hardcastle, Timothy Craig
AU - Jeena, Prakash
AU - Kalafatis, Nicky
AU - Kistan, Kroshlan
AU - Kisten, Theroshnie
AU - Lee, Carolyn
AU - Mitchell, Colin
AU - Moodley, Magesvaran
AU - Morgan, Mary E
AU - Ramkilliwana, Arisha
AU - Ramjee, Rajesh
AU - Reddy, Darshan
AU - Robroch, Afke
AU - Singh, Shivani
AU - von Rahden, Richard
AU - Biccard, Bruce
N1 - Funding Information:
Approval for the study was obtained from the University of KwaZulu-Natal (BE210/14), the hospital management of each institution, and the Provincial Health and Research Ethics Committee of the KwaZulu-Natal Department of Health. Funding was supported by the Discipline of Anaesthesiology and Critical Care (University of KwaZulu-Natal) and the Pietermaritzburg Research Collaborative.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017
Y1 - 2017
N2 - Background: The spectrum of illness and long-term outcome of critically ill patients admitted to intensive care units (ICUs) in South Africa remains largely unknown. Objectives: This study was designed to provide data on ICU outcomes and disease burden in public sector ICUs in KwaZulu- Natal. The primary objective was to describe 30-day mortality of all patients admitted to participating sites. Secondary objectives included clinical demographics and spectrum of illness amongst these patients, and testing a template to demonstrate feasibility of such data collection. Methods: 30DOS was a multicentre, prospective, observational cohort study conducted over 30 days. An a priori decision was made to report study results separately for adults and paediatric patients. This article reports the results for adult patients. The complete 30-DOS study included 11 ICUs in six hospitals. All adult patients admitted to study ICUs were included. Patients were followed up telephonically by a research assistant. Data on patient demographics, preadmission functional scoring, injury severity scoring, co-morbidities, admission diagnosis/es, organ support, and outcome were collected. Results: A total of 228 adults were included. The majority of admissions (73.7%) occurred on an emergency basis, with 68.4% occurring in the postoperative period. Approximately half were for non-communicable disease (49.6%), followed by trauma (29.0%) and infectious disease (21.5%). There were a total of 59 (25.9%) deaths within the first 30 days after admission. In-ICU mortality was 19.7%. There were 12 (5.3%) in-hospital deaths following discharge and two (0.9%) out-of-hospital deaths. Thirtyday survival was known for 174 (76.3%) admissions with a 33.9% mortality rate. Conclusion: Overall in-ICU mortality was 19.7% with a large trauma burden in a young population. Thirty-day mortality was 33.9%. Information pertaining to patient demographics and spectrum of illness provided novel information to further the understanding of the demand placed on critical care resources within South Africa.
AB - Background: The spectrum of illness and long-term outcome of critically ill patients admitted to intensive care units (ICUs) in South Africa remains largely unknown. Objectives: This study was designed to provide data on ICU outcomes and disease burden in public sector ICUs in KwaZulu- Natal. The primary objective was to describe 30-day mortality of all patients admitted to participating sites. Secondary objectives included clinical demographics and spectrum of illness amongst these patients, and testing a template to demonstrate feasibility of such data collection. Methods: 30DOS was a multicentre, prospective, observational cohort study conducted over 30 days. An a priori decision was made to report study results separately for adults and paediatric patients. This article reports the results for adult patients. The complete 30-DOS study included 11 ICUs in six hospitals. All adult patients admitted to study ICUs were included. Patients were followed up telephonically by a research assistant. Data on patient demographics, preadmission functional scoring, injury severity scoring, co-morbidities, admission diagnosis/es, organ support, and outcome were collected. Results: A total of 228 adults were included. The majority of admissions (73.7%) occurred on an emergency basis, with 68.4% occurring in the postoperative period. Approximately half were for non-communicable disease (49.6%), followed by trauma (29.0%) and infectious disease (21.5%). There were a total of 59 (25.9%) deaths within the first 30 days after admission. In-ICU mortality was 19.7%. There were 12 (5.3%) in-hospital deaths following discharge and two (0.9%) out-of-hospital deaths. Thirtyday survival was known for 174 (76.3%) admissions with a 33.9% mortality rate. Conclusion: Overall in-ICU mortality was 19.7% with a large trauma burden in a young population. Thirty-day mortality was 33.9%. Information pertaining to patient demographics and spectrum of illness provided novel information to further the understanding of the demand placed on critical care resources within South Africa.
KW - 30-day mortality
KW - Critical care
KW - Outcome
KW - South Africa
UR - http://www.scopus.com/inward/record.url?scp=85038258758&partnerID=8YFLogxK
U2 - 10.1080/22201181.2017.1402553
DO - 10.1080/22201181.2017.1402553
M3 - Article
AN - SCOPUS:85038258758
SN - 2220-1181
VL - 23
SP - 6
EP - 11
JO - Southern African Journal of Anaesthesia and Analgesia
JF - Southern African Journal of Anaesthesia and Analgesia
IS - 6
ER -