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ICU Survivors Have a Substantial Higher Risk of Developing New Chronic Conditions Compared to a Population-Based Control Group

van Beusekom, Ilse, MSc1,2; Bakhshi-Raiez, Ferishta, PhD1,2; van der Schaaf, Marike, PhD3,4; Busschers, Wim B., MSc1,2; de Keizer, Nicolette F., PhD1,2; Dongelmans, Dave A., MD, PhD2,5

doi: 10.1097/CCM.0000000000003576
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Objectives: To describe the types and prevalence of chronic conditions in an ICU population and a population-based control group during the year before ICU admission and to quantify the risk of developing new chronic conditions in ICU patients compared with the control group.

Design: We conducted a retrospective cohort study, combining a national health insurance claims database and a national quality registry for ICUs. Claims data in the timeframe 2012–2014 were combined with clinical data of patients who had been admitted to an ICU during 2013. To assess the differences in risk of developing new chronic conditions, ICU patients were compared with a population-based control group using logistic regression modeling.

Setting: Eighty-one Dutch ICUs.

Patients: All patients admitted to an ICU during 2013. A population-based control group was created, and weighted on the age, gender, and socio-economic status of the ICU population.

Interventions: None.

Measurements and Main Results: ICU patients (n = 56,760) have more chronic conditions compared with the control group (n = 75,232) during the year before ICU admission (p < 0.0001). After case-mix adjustment ICU patients had a higher risk of developing chronic conditions, with odds ratios ranging from 1.67 (CI, 1.29–2.17) for asthma to 24.35 (CI, 14.00–42.34) for epilepsy, compared with the control group.

Conclusions: Due to the high prevalence of chronic conditions and the increased risk of developing new chronic conditions, ICU follow-up care is advised and may focus on the identification and treatment of the new developed chronic conditions.

1Department of Medical Informatics, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

2National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands.

3Department of Rehabilitation, Amsterdam UMC, Amsterdam Movement Sciences, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

4Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.

5Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal).

Dr. de Keizer’s institution received funding from National Intensive Care Evaluation foundation. The remaining authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: i.vanbeusekom@amc.uva.nl

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