Files and links (2)
Published (Version of Record)CC BY V4.0, Open Access
Journal article
Landmark survival as an end-point for trials in critically ill patients – comparison of alternative durations of follow-up: an exploratory analysis
Critical Care, Vol.13(4), R128
2009
Abstract
Introduction
Interventional ICU trials have followed up patients for variable duration. However, the optimal duration of follow-up for the determination of mortality endpoint in such trials is uncertain. We aimed to determine the most logical and practical mortality end-point in clinical trials of critically ill patients.
Methods
We performed a retrospective analysis of prospectively collected data involving 369 patients with one of the three specific diagnoses (i) Sepsis (ii) Community acquired pneumonia (iii) Non operative trauma admitted to the Royal Perth Hospital ICU, a large teaching hospital in Western Australia (WA cohort). Their in-hospital and post discharge survival outcome was assessed by linkage to the WA Death Registry. A validation cohort involving 4609 patients admitted during same time period with identical diagnoses from 55 ICUs across Australia (CORE cohort) was used to compare the patient characteristics and in-hospital survival to look at the Australia-wide applicability of the long term survival data from the WA cohort.
Results
The long term outcome data of the WA cohort indicate that mortality reached a plateau at 90 days after ICU admission particularly for sepsis and pneumonia. Mortality after hospital discharge before 90 days was not uncommon in these two groups. Severity of acute illness as measured by the total number of organ failures or acute physiology score was the main predictor of 90-day mortality. The adjusted in-hospital survival for the WA cohort was not significantly different from that of the CORE cohort in all three diagnostic groups; sepsis (P = 0.19), community acquired pneumonia (P = 0.86), non-operative trauma (P = 0.47).
Conclusions
A minimum of 90 days follow-up is necessary to fully capture the mortality effect of sepsis and community acquired pneumonia. A shorter period of follow-up time may be sufficient for non-operative trauma.
Details
- Title
- Landmark survival as an end-point for trials in critically ill patients – comparison of alternative durations of follow-up: an exploratory analysis
- Authors/Creators
- G. Taori (Author/Creator) - Austin HospitalK.M. Ho (Author/Creator) - The University of Western AustraliaC. George (Author/Creator) - Australian and New Zealand Intensive Care SocietyR. Bellomo (Author/Creator) - Austin HospitalS.A.R. Webb (Author/Creator) - The University of Western AustraliaG.K. Hart (Author/Creator) - Austin HospitalM.J. Bailey (Author/Creator) - Monash University
- Publication Details
- Critical Care, Vol.13(4), R128
- Publisher
- BioMed Central
- Identifiers
- 991005542350707891
- Copyright
- © 2009 Taori et al
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
UN Sustainable Development Goals (SDGs)
This output has contributed to the advancement of the following goals:
Source: InCites
Metrics
146 File views/ downloads
71 Record Views
InCites Highlights
These are selected metrics from InCites Benchmarking & Analytics tool, related to this output
- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.154 Assisted Ventilation
- 1.154.1088 Intensive Care
- Web Of Science research areas
- Critical Care Medicine
- ESI research areas
- Clinical Medicine