MỐI LIÊN QUAN CỦA THỜI GIAN NẰM VIỆN TRƯỚC NHẬP KHOA HỒI SỨC TÍCH CỰC VÀ KẾT QUẢ ĐIỀU TRỊ

Abstract

Introduction: Pre-intensive care unit (pre-ICU) hospital length of stay is often overlooked in prognostic assessments of critically ill patients. Recent studies have suggested that prolonged pre-ICU stays may be associated with adverse outcomes; however, this relationship has not been thoroughly investigated in the clinical context of Vietnam. Objective: To determine the association between pre-ICU hospital length of stay and clinical outcomes in critically ill patients. Methods: A retrospective cohort study was conducted on 472 patients aged ≥18 years admitted to the ICU of Cho Ray Hospital from January to September 2019. Clinical and laboratory data were collected at ICU admission. Multivariable logistic regression analysis was used to identify factors associated with in-hospital mortality. Results: The in-hospital mortality rate was 44.5%. The mortality group had a significantly longer pre-ICU hospital stay compared to survivors (median: 3 vs. 2 days; p = 0.010). Each additional pre-ICU day increased the odds of death by 6% (adjusted OR: 1.06; 95% CI: 1.03–1.10; p <0.001). Patients with a pre-ICU stay >5 days had significantly higher ICU and in-hospital mortality rates (p <0.05). However, ICU length of stay and duration of mechanical ventilation were not significantly different between groups. Conclusion: Pre-ICU hospital length of stay is an independent predictor of in-hospital mortality and should be considered in risk stratification and care coordination for critically ill patients.