Observational studyCritical care (London, England)2020
The performance of acute versus antecedent patient characteristics for 1-year mortality prediction during intensive care unit admission: a national cohort study.
Observational study in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Lower gastrointestinal tract dysbiosis in persistent critical illness: a systematic review.Journal of medical microbiology · 2024Pooled it
- Development and validation of an interpretable machine learning model using routine laboratory biomarkers to stratify severe pneumonia risk in young children.Journal of advanced research · 2026Article
- Timing of onset of persistent critical illness in Japan: a nationwide registry study.The Lancet regional health. Western Pacific · 2025Article
- Early prediction of mortality upon intensive care unit admission.BMC medical informatics and decision making · 2024Article
- Persistent Critical Illness and Long-Term Outcomes in Patients With COVID-19: A Multicenter Retrospective Cohort Study.Critical care explorations · 2024Article
- Development and evaluation of regression tree models for predicting in-hospital mortality of a national registry of COVID-19 patients over six pandemic surges.BMC medical informatics and decision making · 2024Article
- Contribution of information about acute and geriatric characteristics to decisions about life-sustaining treatment for old patients in intensive care.BMC medical informatics and decision making · 2023Article
- Article
- Data Science Trends Relevant to Nursing Practice: A Rapid Review of the 2020 Literature.Applied clinical informatics · 2022Review
- Predictors of death and new disability after critical illness: a multicentre prospective cohort study.Intensive care medicine · 2021Article
- On predictions in critical care: The individual prognostication fallacy in elderly patients.Journal of critical care · 2021Article
- Microbial findings and the role of difficult-to-treat pathogens in patients with periprosthetic infection admitted to the intensive care unit.Orthopedic reviews · 2020Article
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7 authors.
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Abstract
backgroundMultiple factors contribute to mortality after ICU, but it is unclear how the predictive value of these factors changes during ICU admission. We aimed to compare the changing performance over time of the acute illness component, antecedent patient characteristics, and ICU length of stay (LOS) in predicting 1-year mortality.
methodsIn this retrospective observational cohort study, the discriminative value of four generalized mixed-effects models was compared for 1-year and hospital mortality. Among patients with increasing ICU LOS, the models included (a) acute illness factors and antecedent patient characteristics combined, (b) acute component only, (c) antecedent patient characteristics only, and (d) ICU LOS. For each analysis, discrimination was measured by area under the receiver operating characteristics curve (AUC), calculated using the bootstrap method. Statistical significance between the models was assessed using the DeLong method (p value < 0.05).
resultsIn 400,248 ICU patients observed, hospital mortality was 11.8% and 1-year mortality 21.8%. At ICU admission, the combined model predicted 1-year mortality with an AUC of 0.84 (95% CI 0.84-0.84). When analyzed separately, the acute component progressively lost predictive power. From an ICU admission of at least 3 days, antecedent characteristics significantly exceeded the predictive value of the acute component for 1-year mortality, AUC 0.68 (95% CI 0.68-0.69) versus 0.67 (95% CI 0.67-0.68) (p value < 0.001). For hospital mortality, antecedent characteristics outperformed the acute component from a LOS of at least 7 days, comprising 7.8% of patients and accounting for 52.4% of all bed days. ICU LOS predicted 1-year mortality with an AUC of 0.52 (95% CI 0.51-0.53) and hospital mortality with an AUC of 0.54 (95% CI 0.53-0.55) for patients with a LOS of at least 7 days.
conclusionsComparing the predictive value of factors influencing 1-year mortality for patients with increasing ICU LOS, antecedent patient characteristics are more predictive than the acute component for patients with an ICU LOS of at least 3 days. For hospital mortality, antecedent patient characteristics outperform the acute component for patients with an ICU LOS of at least 7 days. After the first week of ICU admission, LOS itself is not predictive of hospital nor 1-year mortality.
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