Male gender, ISS, or the presence EPZ-5676 Histone Methyltransferase of cardiopulmonary arrest, pneumonia, acute respiratory distress syndrome (ARDS), respiratory failure requiring intubation or re-intubation, urinary tract infection, deep vein thrombosis, arrhythmias, sepsis, or gastrointestinal bleed were found to be independent predictors of LOS of more than 30 days (Table (Table4).4). The occurrences of sepsis and ARDS, in particular, increased the odds by 5.0 and 8.8, respectively, of prolonging ICU stay of more than 30 days. This model correctly predicted 96% of outcomes. An increase in the ISS of 1 resulted in a 4% increase in the odds of ICU LOS >30 days.Table 4Independent predictors of intensive care unit length of stay of 30 days or longer by logistic regression analysisILOS>30 group: survivors versus non-survivorsWithin the ILOS>30 group, non-survivors were significantly older and had longer durations of mechanical ventilation (Table (Table5).

5). ISS and GCS on admission were similar. Univariate analysis showed that besides age and female gender, death was significantly associated with pre-existing cardiac, renal and neurological conditions, and the following complications: myocardial infarction, arrhythmias, renal failure, ARDS and the requirement for renal replacement therapy.Table 5Characteristics of the group of patients with intensive care unit length of stay more than 30 days by survival statusAfter variables with P < 0.2 by univariate analysis were entered into a logistic regression analysis, age, pre-existing renal conditions and need for renal replacement therapy emerged as independent predictors of death in the ILOS>30 group.

The odds of death increased by 4.7 and 9.1, respectively, if there was a need for dialysis and if there was a pre-existing renal condition. With every year of age, the odds of death increased by 5%. This model correctly predicted outcomes in 88% of patients. Cause of death was multiple-organ failure (MOF) in 22 patients, acute respiratory failure in two patients and sudden massive hemoptysis due to necrotizing Mycobacterium pneumonia in one. Overall mortality rate in the ILOS>30 group was 12%.Discharge destinations for survivorsSixty-one percent of patients with ICU LOS of less than 30 days were discharged home as compared with 8% of patients with ICU LOS of 30 days or more (P < 0.001; Table Table6).6).

The majority of the ILOS>30 survivors were transferred to inpatient rehabilitation centers (55%) and skilled nursing facilities (28%).Table 6Discharge destinations for survivors (ILOS<30 versus ILOS>30)DiscussionOnly a few studies have specifically addressed prolonged ICU stays in trauma patients. Trottier and colleagues [3] analyzed 339 trauma and burn patients with ICU LOS of more Batimastat than 28 days and found similar survival rates (87%) to our study with age being the most important predictor of outcome.