Influence of social characteristics on the duration of treatment, severity of the disease and social support of patients in a surgical intensive care unit

Abstract

In critical illnesses low socioeconomic status (SES) is associated with higher morbidity and mortality. In addition to the SES, further factors at an individual level (e.g., sex, health insurance status and place of residence) may influence the severity of illness and medical treatment. We investigated these additional parameters in asecondary analysis of the ECSSTASI data. Within the framework of the ECSSTASI study, 996patients were recruited from asurgical intensive care unit. We examined the influence of sex, insurance status and place of residence on health-related behavior, disease severity, duration of intensive care and ventilation (28ventilator-free days score, 28-VFDS) and social support by the next of kin. Multivariate-adjusted logistic regression analyses were carried out and odds ratios (OR) are presented with corresponding 95% confidence intervals. Among patients admitted to the intensive care unit, the disease severity (SOFA score >5) was significantly lower in women than in men (OR 0.62 [0.45-0.87]). Increasing size of the patient's town of residence was associated with asignificantly shorter duration of treatment on the intensive care unit (OR 0.54 [0.32-0.91]). An increasing number of persons in the household was associated with asignificantly increased risk of being ventilated longer compared to 1‑person households (p = 0.028). Patients with private insurance (OR1.87 [1.28-2.70]), patients from households with ≥4 persons (OR1.92 [1.1-3.33]) and patients without German citizenship (OR2.56 [1.39-4.55]) were visited significantly more often by next of kin. In addition to the SES, sociodemographic characteristics of the individual patient are associated with the course of treatment in intensive care medicine. The extent of social support by the next of kin depends on intercultural and individual patient characteristics. An increasing size of the town of residence and private health insurance status positively influence intensive care outcomes. In order to evaluate these data, further epidemiological studies in intensive care medicine are necessary.