Editor's Choice
ANESTHESIOLOGY / CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Intensive care unit (ICU) hospitalizations are one of the major burdens on the healthcare system, and they may be related to high risk of in-hospital fatality. The aim of the study was to describe long-term trends in ICU hospitalizations and related fatality rates in Poland.

Material and methods:
It was a population-based study based on 738,579 ICU hospitalization records in 2012–2021.

Results:
Based on the hospital registry and data on the general population, the mean annual ICU hospitalization incidence was estimated at 1.9 per 1,000 (SD = 0.17). A significant increasing trend in hospitalizations was observed from 1.6 per 1,000 in 2012 to 2.2 per 1,000 in 2021, p < 0.005. We observed a significant predominance of male patients (56.6% p < 0.001) in the study group when compared to the general population. The mean and median age in the study group were 61.6 (SD = 18.2) and 65 years (IQR: 53–74), respectively. Linear regression analysis demonstrated a significant upward trend in fatal hospitalizations from 37.7% in 2012 to 46.5% in 2021, p < 0.05. Similarly, fatal ICU stays increased significantly from 31.2% to 42.5% over the same period, p < 0.01. The mean length of ICU stays increased from 8.7 in 2012 to 10.1 days in 2021, p < 0.001.

Conclusions:
The paper presents the recent trends in quantitative and qualitative changes in ICU hospitalizations in Poland. The presented data may constitute the basis for comparative analyses in a global context. Our findings suggest that adaptive systemic changes are necessary to improve health care.
REFERENCES (44)
1.
Seymour CW, Iwashyna TJ, Ehlenbach WJ, Wunsch H, Cooke CR. Hospital-level variation in the use of intensive care. Health Serv Res 2012; 47: 2060-80.
 
2.
Villgran VD, Lyons C, Nasrullah A, Clarisse Abalos C, Bihler E, Alhajhusain A. Acute respiratory failure. Crit Care Nurs Q 2022; 45: 233-47.
 
3.
Fleischmann-Struzek C, Mellhammar L, Rose N, et al. Incidence and mortality of hospital- and ICU-treated sepsis: results from an updated and expanded systematic review and meta-analysis. Intensive Care Med 2020; 46: 1552-62.
 
4.
Chen C, Wu X, Zhang W, et al. Predictive value of risk factors for prognosis of patients with sepsis in intensive care unit. Medicine (Baltimore) 2023; 102: e33881.
 
5.
Garland A, Olafson K, Ramsey CD, Yogendran M, Fransoo R. A population-based observational study of intensive care unit-related outcomes. With emphasis on post-hospital outcomes. Ann Am Thorac Soc 2015; 12: 202-8.
 
6.
Wong EG, Parker AM, Leung DG, Brigham EP, Arbaje AI. Association of severity of illness and intensive care unit readmission: a systematic review. Heart Lung 2016; 45: 3-9.e2.
 
7.
Martin GL, Atramont A, Mazars M, et al. Days spent at home and mortality after critical illness: a cluster analysis using nationwide data. Chest 2023; 163: 826-42.
 
8.
de Lima VCBF, Bierrenbach AL, Alencar GP, Andrade AL, Azevedo LCP. Increased risk of death and readmission after hospital discharge of critically ill patients in a developing country: a retrospective multicenter cohort study. Intensive Care Med 2018; 44: 1090-6.
 
9.
Mady AF, Al-Odat MA, Alshaya R, et al. Mortality rates in early versus late intensive care unit readmission. Saudi J Med Med Sci 2023; 11: 143-9.
 
10.
Ponzoni CR, Corrêa TD, Filho RR, et al. Readmission to the intensive care unit: incidence, risk factors, resource use, and outcomes. a retrospective cohort study. Ann Am Thorac Soc 2017; 14: 1312-9.
 
11.
E Silva LGA, de Maio Carrilho CMD, Talizin TB, Cardoso LTQ, Lavado EL, Grion CMC. Risk factors for hospital mortality in intensive care unit survivors: a retrospective cohort study. Acute Crit Care 2023; 38: 68-75.
 
12.
Vallet H, Schwarz GL, Flaatten H, de Lange DW, Guidet B, Dechartres A. Mortality of older patients admitted to an ICU: a systematic review. Crit Care Med 2021; 49: 324-34.
 
13.
Prabhudev P, Ramamoorthi K, Acharya RV. A clinical and demographic profile of elderly (>65 years) in the medical intensive care units of a tertiary care center. Indian J Crit Care Med 2023; 27: 166-75.
 
14.
Jo M, Lee Y, Kim T. Medical care costs at the end of life among older adults with cancer: a national health insurance data-based cohort study. BMC Palliat Care 2023; 22: 76.
 
15.
Alsallakh M, Tan L, Pugh R, et al. Patterns of healthcare resource utilisation of critical care survivors between 2006 and 2017 in Wales: a population-based study. J Clin Med 2023; 12: 872.
 
16.
Lee Y, Jo M, Kim T, Yun K. Analysis of high-intensity care in intensive care units and its cost at the end of life among older people in South Korea between 2016 and 2019: a cross-sectional study of the health insurance review and assessment service national patient sample database. BMJ Open 2021; 11: e049711.
 
17.
Guidelines of the Polish Society of Anaesthesiology and Intensive Care specifying the qualification rules and criteria for admitting patients to the Departments of Anaesthesiology and Intensive Care - February 2012 [Article in Polish]. https://anestezjologia.org.pl/... Accessed on 03 September 2023.
 
18.
PTAiIT guidelines specifying the qualification rules and criteria for admitting patients to the Departments of Anaesthesiology and Intensive Care [Article in Polish]. https://www.anestezjologia.org... Accessed on 3 September 2023.
 
19.
Weigl W, Adamski J, Goryński P, Kański A, Hultström M. ICU mortality and variables associated with ICU survival in Poland: a nationwide database study. Eur J Anaesthesiol 2018; 35: 949-54.
 
20.
Weigl W, Adamski J, Goryński P, Kański A, Hultström M. Mortality rate is higher in Polish intensive care units than in other European countries. Intensive Care Med 2017; 43: 1430-2.
 
21.
Bohula EA, Katz JN, van Diepen S, et al. Demographics, care patterns, and outcomes of patients admitted to cardiac intensive care units: the critical care cardiology trials network prospective north american multicenter registry of cardiac critical illness. JAMA Cardiol 2019; 4: 928-35.
 
22.
Goldfarb M, van Diepen S, Liszkowski M, Jentzer JC, Pedraza I, Cercek B. Noncardiovascular disease and critical care delivery in a contemporary cardiac and medical intensive care unit. J Intensive Care Med 2019; 34: 537-43.
 
23.
TIBCO Software Inc. Statistica (Data Analysis Software System), Version 13. http://statistica.io. 2017.
 
24.
Abramson JH WINPEPI Updated: Computer Programs for Epidemiologists, and Their Teaching Potential. Epidemiol Persp 2011; 8: 1.
 
25.
Statistics Poland. https://stat.gov.pl; [Accessed on 04 February 2023].
 
26.
Vestergaard AHS, Christiansen CF, Nielsen H, Christensen S, Johnsen SP. Geographical variation in use of intensive care: a nationwide study. Intensive Care Med 2015; 41: 1895-902.
 
27.
Park J, Jeon K, Chung CR, et al. A nationwide analysis of intensive care unit admissions, 2009-2014 - The Korean ICU National Data (KIND) study. J Crit Care 2018; 44: 24-30.
 
28.
Sadiq AM, Kilonzo KG. Pattern of diseases and clinical outcomes in medical intensive care unit at a tertiary hospital in northeastern Tanzania: a three-year retrospective study. PLoS One 2023; 18: e0282269.
 
29.
National Population and Housing Census 2021 Population ageing in Poland in the light of the results of the 2021 Census. Statistics Poland. Warsaw 2023. Page 14. https://stat.gov.pl/download/g.... Accessed on 28 January 2024.
 
30.
Oud L. Intensive Care Unit (ICU) – Managed Elderly Hospitalizations with Dementia in Texas, 2001-2010: a population-level analysis. Med Sci Monit 2016; 22: 3849-59.
 
31.
Moran JL, Bristow P, Solomon PJ, George C, Hart GK, Australian and New Zealand Intensive Care Society Database Management Committee (ADMC). Mortality and length-of-stay outcomes, 1993-2003, in the binational Australian and New Zealand intensive care adult patient database. Crit Care Med 2008; 36: 46-61.
 
32.
Pijls BG, Jolani S, Atherley A, et al. Demographic risk factors for COVID-19 infection, severity, ICU admission and death: a meta-analysis of 59 studies. BMJ Open 2021; 11: e044640.
 
33.
Pijls BG, Jolani S, Atherley A, et al. Temporal trends of sex differences for COVID-19 infection, hospitalisation, severe disease, intensive care unit (ICU) admission and death: a meta-analysis of 229 studies covering over 10M patients. F1000Res 2022; 11: 5.
 
34.
Gunasekaran S, Mahadevaiah S. Healthcare-associated infection in intensive care units: overall analysis of patient criticality by acute physiology and chronic health evaluation iv scoring and pathogenic characteristics. Indian J Crit Care Med 2020; 24: 252-7.
 
35.
Rodríguez-Carvajal M, Mora D, Doblas A, et al. [Impact of the premature discharge on hospital mortality after a stay in an intensive care unit]. Med Intensiva 2011; 35: 143-9.
 
36.
Iwashyna TJ, Hodgson CL, Pilcher D, et al. Timing of onset and burden of persistent critical illness in Australia and New Zealand: a retrospective, population-based, observational study. Lancet Respir Med 2016; 4: 566-73.
 
37.
Ferrer M, Torres A. Epidemiology of ICU-acquired pneumonia. Curr Opin Crit Care 2018; 24: 325-31.
 
38.
Hill AD, Fowler RA, Pinto R, Herridge MS, Cuthbertson BH, Scales DC. Long-term outcomes and healthcare utilization following critical illness--a population-based study. Crit Care 2016; 20: 76.
 
39.
Lim ZJ, Subramaniam A, Ponnapa Reddy M, et al. Case fatality rates for patients with COVID-19 requiring invasive mechanical ventilation. A meta-analysis. Am J Respir Crit Care Med 2021; 203: 54-66.
 
40.
Alimohamadi Y, Tola HH, Abbasi-Ghahramanloo A, Janani M, Sepandi M. Case fatality rate of COVID-19: a systematic review and meta-analysis. J Prev Med Hyg 2021; 62: E311-20.
 
41.
Grasselli G, Greco M, Zanella A, et al. Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med 2020; 180: 1345-55.
 
42.
Illescas AH, Kache PA, Whittemore K, et al. Hospitalizations involving an intensive care unit admission among patients aged 65 years and older within New York City Hospitals during 2000-2014. Med Care 2020; 58: 74-82.
 
43.
Miniksar ÖH, Özdemir M. Clinical features and outcomes of very elderly patients admitted to the intensive care unit: a retrospective and observational study. Indian J Crit Care Med 2021; 25: 629-34.
 
44.
Choi J, Park E, Choi AY, Son MH, Cho J. Incidence and mortality trends in critically ill children: a korean population-based study. J Korean Med Sci 2023; 38: e178.
 
eISSN:1896-9151
ISSN:1734-1922
Journals System - logo
Scroll to top