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The burden of critical illness among adults in a Swedish region-a population-based point-prevalence study
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Medicine, Nyköping Hospital, Sörmland Region, Nyköping, Sweden.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Anaesthesia and Intensive Care, Nyköping Hospital, Sörmland Region, Nyköping, Sweden.
Department of Surgical Sciences, Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden; Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden.
Örebro University, School of Medical Sciences. Department of Emergency Medicine, Örebro University, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-3290-4111
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2023 (English)In: European Journal of Medical Research, ISSN 0949-2321, E-ISSN 2047-783X, Vol. 28, no 1, article id 322Article in journal (Refereed) Published
Abstract [en]

Background: Patients with critical illness have a high risk of mortality. Key decision-making in the health system affecting the outcomes of critically ill patients requires epidemiological evidence, but the burden of critical illness is largely unknown. This study aimed to estimate the prevalence of critical illness in a Swedish region. Secondary objectives were to estimate the proportion of hospital inpatients who are critically ill and to describe the in-hospital location of critically ill patients.

Methods: A prospective, multi-center, population-based, point-prevalence study on specific days in 2017-2018. All adult (> 18 years) in-patients, regardless of admitting specially, in all acute hospitals in Sörmland, and the patients from Sörmland who had been referred to university hospitals, were included. Patients in the operating theatres, with a psychiatric cause of admission, women in active labor and moribund patients, were excluded. All participants were examined by trained data collectors. Critical illness was defined as "a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided and a potential for reversibility". The presence of one or more severely deranged vital signs was used to classify critical illness. The prevalence of critical illness was calculated as the number of critically ill patients divided by the number of adults in the region.

Results: A total of 1269 patients were included in the study. Median age was 74 years and 50% of patients were female. Critical illness was present in 133 patients, resulting in an adult population prevalence of critical illness per 100,000 people of 19.4 (95% CI 16.4-23.0). The proportion of patients in hospital who were critically ill was 10.5% (95% CI 8.8-12.3%). Among the critically ill, 125 [95% CI 94.0% (88.4-97.0%)] were cared for in general wards.

Conclusions. The prevalence of critical illness was higher than previous, indirect estimates. One in ten hospitalized patients were critically ill, the large majority of which were cared for in general wards. This suggests a hidden burden of critical illness of potential public health, health system and hospital management significance.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023. Vol. 28, no 1, article id 322
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Nursing
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URN: urn:nbn:se:oru:diva-108194DOI: 10.1186/s40001-023-01279-0ISI: 001064985300003PubMedID: 37679836Scopus ID: 2-s2.0-85170177206OAI: oai:DiVA.org:oru-108194DiVA, id: diva2:1795865
Funder
Karolinska Institute
Note

Funding agencies:

Centre for Clinical Research Soermland, Uppsala University, Sweden (COS) DLL-652801

Regional Research Council Mid Sweden (COS, AW) RFR-931271

 

Available from: 2023-09-11 Created: 2023-09-11 Last updated: 2024-01-16Bibliographically approved

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