{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:08:01Z","timestamp":1723075681324},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>IMPORTANCE:<\/jats:title>\n            <jats:p>Prognostication following ICU admission can often be determined based on known risk factors, including demographics and illness severity; however, little is known about outcomes of patients deemed to be \u201clow-risk\u201d at the time of hospital admission who subsequently are admitted to the ICU.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVES:<\/jats:title>\n            <jats:p>The objectives of this study were to determine the characteristics, outcomes, and costs for patients requiring ICU admission despite having lower predicted mortality when they were admitted to the hospital.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>DESIGN, SETTING, AND PARTICIPANTS:<\/jats:title>\n            <jats:p>In this historical cohort study, we used a prospectively maintained ICU registry that included all ICU admissions to The Ottawa Hospital for patients 18 years or older from January 2011 to December 2016. We classified patients as low-risk using the Hospital-patient 1-year Mortality Risk at admission score, a hospital admission score validated to predict 1-year mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>MAIN OUTCOMES AND MEASURES:<\/jats:title>\n            <jats:p>The primary outcome was inhospital mortality. Secondary outcomes included adverse events, resource utilization, and costs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Of the 17,173 total ICU patients, 3,445 (20.1%) were classified as low-risk at hospital admission. Low-risk patients were younger (48.7 vs 67.5 yr; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001) and had a lower Multiple Organ Dysfunction Score (2.37 vs 4.14; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001). Mortality for low-risk patients was significantly lower than for non\u2013low-risk patients (4.1% vs 25.4%; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001). For low-risk patients, multivariable logistic regression showed mortality was independently associated with older age (odds ratio, 1.02 per 1 yr; 95% CI, 1.00\u20131.03 per 1 yr), Multiple Organ Dysfunction Score (odds ratio, 1.42 per 1 point; 95% CI, 1.31\u20131.54 per 1 point), fluid management adverse events (odds ratio, 2.84; 95% CI, 1.29\u20136.25), hospital-acquired infections (odds ratio, 1.60; 95% CI, 1.02\u20132.51), and mechanical ventilation (odds ratio, 1.98; 95% CI, 1.20\u20133.26).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS AND RELEVANCE:<\/jats:title>\n            <jats:p>Despite their robust premorbid status, low-risk patients admitted to the ICU had significant inhospital mortality. Fluid management adverse events, hospital-associated infections, multiple organ dysfunction, and mechanical ventilation are important prognostic factors for low-risk patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/cce.0000000000000596","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T21:29:34Z","timestamp":1639085374000},"page":"e0596","update-policy":"http:\/\/dx.doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics and Outcomes for Low-Risk Hospital Admissions Admitted to the ICU: A Multisite Cohort Study"],"prefix":"10.1097","volume":"3","author":[{"given":"Ross T.","family":"Prager","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, ON, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael T.","family":"Pratte","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ottawa, 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