Identification of Factors Associated with Prolonged Stay in the Intensive Care Unit

Abstract

Objective: This study aimed to determine the factors associated with prolonged intensive care unit length of stay (ICU-LOS), which is increasingly common in ICU, and to evaluate its effect on patient outcomes. Methods: This retrospective study was evaluated by obtaining data of 5,022 patients who were followed in the ICU of a tertiary education and research hospital between January 2014 and January 2021 and met the research criteria in electronic environment. Results: Patients were divided into two groups as patients with ICU-LOS <14 days (n=4,083, 81.3%) and patients with ICU-LOS >= 14 days (n=939, 18.7%). Sepsis and pulmonary diseases were more common in the prolonged ICU-LOS group than in the non-prolonged ICU-LOS group (p<0.05). While 61.8% (2,525) in the non-prolonged ICU-LOS group needed mechanical ventilator support, this rate increased to 97.4% (915) in the prolonged ICU-LOS group (p<0.001). The duration of MV was higher in the prolonged ICU-LOS group [20.3 (14.9-29.2)] than in the non-prolonged ICU-LOS group [3.4 (1.7-6.2)] (p>0.001). Although 18.7% of the patients had prolonged ICU-LOS, they consumed 66.3% and 59.7% of all mechanical ventilator days and ICU hospitalization days, respectively. ICU mortality was higher in the prolonged ICU-LOS group (n=376; 40%) than in the non-prolonged ICU-LOS group (n=1219; 29.9%). The development of acute kidney injury (odds ratio (OR): 1,807; 95% confidence interval (CI) 1,434-2,277), development of pressure sores (OR: 3,572; 95% CI: 2,663-4,792), total parenteral nutrition use (OR: 2,014; 95% CI: 1,639-2,475), increase in body mass index (OR: 1,015; 95% CI: 1.001-1.031), and mechanical power increase (OR: 1.041; 95% CI: 1.0021.082) were associated with prolonged ICU-LOS (OR: 1.015; 95% CI: 1.001-1.031). Conclusion: Prolonged ICU-LOS is associated with increased costs, use of resources, and morbidity and mortality.