Distinct determinants of long-term and short-term survival in XXXX .

@entity1 @entity3124 @entity204
PURPOSE: To identify the determinants of short-term and long-term survival in adult @entity1 admitted to intensive care units (ICUs). METHODS: This population-based, observational cohort study included all eleven adult ICUs in the Winnipeg Health Region of Manitoba, Canada, analyzing initial ICU admissions during the period 1999-2010 of all Manitobans >= 17 years old. Analysis included Kaplan-Meier survival curves and multivariable regression models of 30-day mortality and post-90-day survival among those who survived to day 90. We used likelihood ratios to compare the predictive power of clusters of variables in these models. RESULTS: After 33,324 initial ICU admissions, mortality rates within 30 and 90 days were 15.9 and 19.5 %, respectively. The survival curve demonstrated an early phase with a high rate of @entity204 , followed by a markedly lower @entity204 rate that was only clearly established after several months. 30-day mortality was predominantly determined by characteristics of the acute illness; with its relative contribution set at 1.00, the next largest contributors were age (0.19) and comorbidity (0.16). In contrast, post-90-day mortality was mainly determined by age (relative contribution 1.00) and comorbidity (0.95); the next largest contributor was characteristics of acute illness (0.28). CONCLUSIONS: We observed two phases of survival related to @entity3124 . Short-term mortality was mainly determined by the acute illness, but its effect decayed relatively rapidly. Mortality beyond 3 months, among those who survived to that point, was mainly determined by age and comorbidity. Recognition of these findings is relevant to discussions with @entity1 and surrogates about achievable goals of care.
