Hospital Mortality Clinical Trial
Official title:
International Multicenter Study of In-hospital Outcome of Patients After ICU Discharge
Several patients die in the intensive care unit (ICU) due to their acute disease and
comorbid conditions. Moreover, after ICU discharge, some ICU survivors still die in the
wards.
Previous studies have shown that the clinical condition of the patient at the time of ICU
discharge may influence in-hospital prognosis. Non-modifiable factors, such as age and
comorbid conditions certainly play a role. But inflammatory status (especially C-reactive
protein - CRP), Sequential organ failure score (SOFA) score and Therapeutic intervention
scoring system (TISS) 28 score have also been related with the risk of hospital death.
Admission to a high dependency unit may reduce the ICU length of stay (LOS). This strategy
may also help to improve prognosis contributing to further stabilize the patient, facilitate
his autonomy and the removal of invasive devices. However the benefit of a step-down
strategy (from ICU to a high dependency unit) has never been evaluated.
The development of a score to evaluate the risk of patients discharged from the ICU may help
to improve the allocation of resources, either to prolong the ICU stay, or admission to a
high dependency units or the ward.
Methods Prospective, observational, international, multicentre study to be conducted in 2
countries (Portugal, Brazil). Inclusion criteria: Each centre may include a maximum of 110
consecutive patients discharged from the ICU with length of stay (LOS)>24h during a 6 month
period.
Exclusion criteria: Limitation of care decision Primary objective: To determine the impact
in hospital mortality and LOS (ICU and hospital) of a step-down strategy, from the ICU to a
high dependency unit, before admission to the ward.
Secondary objectives: To develop and validate a score of the risk of death in the hospital
after discharge from the ICU
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Observational Model: Cohort, Time Perspective: Prospective
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