Long-term prognosis for patients admitted to a medical intermediate care unit.

Abstract

The intermediate care unit at Akershus University Hospital treats patients with incipient or manifest organ failure. Selecting patients who might benefit from treatment in an intermediate care unit is challenging. Few data are available on long-term survival of patients treated in medical intermediate care units and on how assumed favourable and unfavourable prognostic factors predict long-term survival in this population. Comorbidity, reason for admission and whether an infection was a direct or contributory reason for the admission were prospectively registered for patients in the unit in 2014and 2016. We registered mortality up to six years after the admission and conducted a logistic regression analysis with three-year survival as the outcome variable. Of the 2170included patients, 153 (7%) died in the intermediate care unit. Of the 2017patients who were discharged alive from the intermediate care unit, 55% were still alive three years later, including 28% of older patients aged over 80years and 23% of patients with cancer. Age, malignancy, other comorbidity and infection were predictors of mortality. Many patient groups in an intermediate care unit have a poor long-term prognosis. However, people older than 80years, cancer patients or patients with another serious comorbidity may live long after their stay in an intermediate care unit, and the fact of belonging to these groups should not be an independent reason for withholding treatment.