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Critical Care
Published in: Critical Care 1/2018

Open Access 01-12-2018 | Research

Determinants of long-term outcome in ICU survivors: results from the FROG-ICU study

Authors: Etienne Gayat, Alain Cariou, Nicolas Deye, Antoine Vieillard-Baron, Samir Jaber, Charles Damoisel, Qin Lu, Xavier Monnet, Isabelle Rennuit, Elie Azoulay, Marc Léone, Heikel Oueslati, Bertrand Guidet, Diane Friedman, Antoine Tesnière, Romain Sonneville, Philippe Montravers, Sébastien Pili-Floury, Jean-Yves Lefrant, Jacques Duranteau, Pierre-François Laterre, Nicolas Brechot, Karine Chevreul, Morgane Michel, Bernard Cholley, Matthieu Legrand, Jean-Marie Launay, Eric Vicaut, Mervyn Singer, Matthieu Resche-Rigon, Alexandre Mebazaa

Published in: Critical Care | Issue 1/2018

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Abstract

Background

Intensive care unit (ICU) survivors have reduced long-term survival compared to the general population. Identifying parameters at ICU discharge that are associated with poor long-term outcomes may prove useful in targeting an at-risk population. The main objective of the study was to identify clinical and biological determinants of death in the year following ICU discharge.

Methods

FROG-ICU was a prospective, observational, multicenter cohort study of ICU survivors followed 1 year after discharge, including 21 medical, surgical or mixed ICUs in France and Belgium. All consecutive patients admitted to intensive care with a requirement for invasive mechanical ventilation and/or vasoactive drug support for more than 24 h following ICU admission and discharged from ICU were included. The main outcome measure was all-cause mortality at 1 year after ICU discharge. Clinical and biological parameters on ICU discharge were measured, including the circulating cardiovascular biomarkers N-terminal pro-B type natriuretic peptide, high-sensitive troponin I, bioactive-adrenomedullin and soluble-ST2. Socioeconomic status was assessed using a validated deprivation index (FDep).

Results

Of 1570 patients discharged alive from the ICU, 333 (21%) died over the following year. Multivariable analysis identified age, comorbidity, red blood cell transfusion, ICU length of stay and abnormalities in common clinical factors at the time of ICU discharge (low systolic blood pressure, temperature, total protein, platelet and white cell count) as independent factors associated with 1-year mortality. Elevated biomarkers of cardiac and vascular failure independently associated with 1-year death when they are added to multivariable model, with an almost 3-fold increase in the risk of death when combined (adjusted odds ratio 2.84 (95% confidence interval 1.73–4.65), p < 0.001).

Conclusions

The FROG-ICU study identified, at the time of ICU discharge, potentially actionable clinical and biological factors associated with poor long-term outcome after ICU discharge. Those factors may guide discharge planning and directed interventions.

Trial registration

ClinicalTrials.gov NCT01367093. Registered on 6 June 2011.
Appendix
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Metadata
Title
Determinants of long-term outcome in ICU survivors: results from the FROG-ICU study
Authors
Etienne Gayat
Alain Cariou
Nicolas Deye
Antoine Vieillard-Baron
Samir Jaber
Charles Damoisel
Qin Lu
Xavier Monnet
Isabelle Rennuit
Elie Azoulay
Marc Léone
Heikel Oueslati
Bertrand Guidet
Diane Friedman
Antoine Tesnière
Romain Sonneville
Philippe Montravers
Sébastien Pili-Floury
Jean-Yves Lefrant
Jacques Duranteau
Pierre-François Laterre
Nicolas Brechot
Karine Chevreul
Morgane Michel
Bernard Cholley
Matthieu Legrand
Jean-Marie Launay
Eric Vicaut
Mervyn Singer
Matthieu Resche-Rigon
Alexandre Mebazaa
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2018
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-017-1922-8

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