Intermediate outcome of medical patients after intensive care

Medical patients suffer a high mortality after critical illness; however, t he causes of mortality after intensive care management are unclear. This st udy's aims were to (a) explore what factors affect outcome after intensive care and (b) identify medical patients at particularly high risk of mortali ty. During one year, all patients admitted with a medical cause to the Crit ical Care Complex were enrolled. Diagnosis on admission was recorded, and w hether the reason for admission was a new clinical problem or an exacerbati on of existing chronic illness. All patients were followed for a minimum of one year. A total of 186 medical patients were included in the study. Fift y-four medical patients died on intensive care (28.4% mortality), a further 16 died on the general ward after intensive care unit discharge (hospital mortality 36.8%) and six following discharge home (1 year's mortality 40.9% ). Of the 16 patients who died on the general ward, 12 had been admitted to the intensive care unit with a new, previously unrecognised problem rather than exacerbation of a chronic pre-existing problem. However, on the gener al ward, 'Do Not Resuscitate' orders were placed on seven of these 12 patie nts. It would appear that some of the high post intensive care hospital mor tality might be due to changes in resuscitation status in patients expected to survive following intensive care unit discharge.