ArticlePloS one2017
Characteristics, clinical course, and outcomes of homeless and non-homeless patients admitted to ICU: A retrospective cohort study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 30 citations in OpenAlex.
- Implementation and outcomes of a multifaceted care model for people experiencing homelessness and people who inject drugs hospitalized with complicated infections.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Social Precariousness and the Outcome of Critical Illnesses in People with HIV: A Multicenter Cohort Study.Open forum infectious diseases · 2025Article
- The Unhoused Burn Population: An Alarming Increase of Leaving Against Medical Advice.Journal of burn care & research : official publication of the American Burn Association · 2025Article
- An Equity, Diversity, and Inclusion glossary for sociodemographic determinants of health within critical care medicine.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Review
- Association of socioeconomic deprivation with outcomes in critically ill adult patients: an observational prospective multicenter cohort study.Annals of intensive care · 2024Article
- Comparison of Causes of Mortality Between Hospitalized Unsheltered Homeless Patients and Non-Homeless Sex and Age-Matched Controls: A Retrospective Case-Control Study.International journal of public health · 2024Article
- Critical illness among patients experiencing homelessness: a retrospective cohort study.Critical care (London, England) · 2023Article
- Defining Community-Acquired Pneumonia as a Public Health Threat: Arguments in Favor from Spanish Investigators.Medical sciences (Basel, Switzerland) · 2020Article
- Non-communicable Disease among Homeless Men in Nagoya, Japan: Relationship between Metabolic Abnormalities and Sociodemographic Backgrounds.Internal medicine (Tokyo, Japan) · 2020Article
- Epidemiology, Characteristics, and Outcomes of ICU-Managed Homeless Patients: A Population-Based Study.BioMed research international · 2018Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about homeless patients in intensive care units (ICUs).
objectivesTo compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital.
methods63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients.
resultsCompared to matched non-homeless, homeless patients (average age 48±12 years, 90% male, 87% admitted by ambulance, 56% mechanically ventilated, average APACHE II 17) had similar comorbidities and illness severity except for increased alcohol (70% vs 17%,p<0.001) and illicit drug(46% vs 8%,p<0.001) use and less documented hypertension (16% vs 40%,p = 0.005) or prescription medications (48% vs 67%,p<0.05). Intensity of ICU interventions was similar except for higher thiamine (71% vs 21%,p<0.0001) and nicotine (38% vs 14%,p = 0.004) prescriptions. Homeless patients exhibited significantly lower Glasgow Coma Scores and significantly more bacterial respiratory cultures. Longer durations of antibiotics, vasopressors/inotropes, ventilation, ICU and hospital lengths of stay were not statistically different, but homeless patients had higher hospital mortality (29% vs 8%,p = 0.005). Review of all deaths disclosed that withdrawal of life-sustaining therapy occurred in similar clinical circumstances and proportions in both groups, regardless of family involvement. Using multivariable logistic regression, homelessness did not appear to be an independent predictor of hospital mortality.
conclusionsHomeless patients, admitted to ICU matched to non-homeless patients by age and sex (characteristics most commonly used by clinicians), have higher hospital mortality despite similar comorbidities and illness severity. Trends to longer durations of life supports may have contributed to the higher mortality. Additional research is required to validate this higher mortality and develop strategies to improve outcomes in this vulnerable population.
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