METİN DİNÇER, Kadriye KAHVECİ, Cihan DÖĞER

An examination of factors affecting the length of stay in long-term intensive care

With increased life expectancy, developments in intensive care (IC) and applications, there has been an increase in the length of stay of patients in IC Unit (ICU) in recent years. The aim of this study was to examine factors affecting the Length of Stay (LOS) in long-term ICU (LTICU)A total of 503 patients were included and the effects of variables were evaluated such as age, gender, comorbidities, tracheostomy, nutrition, mechanical ventilator (MV) support, and bacteria produced in cultures, which were predicted to have a clinical effect on the LOS in LTICU. The mean LOS in LTICU was 47.6±52.9 days. The LOS was determined to be increased 0.408-fold in patients with tracheostomy, 0.678-fold with Proteus spp production in cultures and 0.400-fold with E. coli production (p

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WHO: http://www.who.int/ageing/en/ access date 06.30.2017

TUIK: http://www.tuik.gov.tr/PdfGetir.do?id=18618 (visit 10.30.2016). 2015.

Rimachi R, Vincent JL, Brimioulle S. Survival and quality of life after prolonged intensive care unit stay. Anaesth Intensive Care. 2007;35(1):62-7.

Kahn JM, Benson NM, Appleby D, Carson SS, Iwashyna TJ. Long-term acute care hospital utilization after critical illness. Jama .2010;303(22):2253-9.

Commission MPA: Report to the Congress: New approaches in Medicare: Medicare Payment Advisory Commission; 2004.

Eskildsen MA. Long-term acute care: a review of the literature. J Am Geriatr Soc. 2007;55(5):775-9.

Munoz-Price LS. Long-term acute care hospitals. Clin Infect Dis. 2009;49(3):438-43.

Friedman R, Kalant N. Comparison of long-term care in an acute care institution and in a long-term care institution. Cmaj. 1998;159(9):1107-13.

Carson SS. Know your long-term care hospital. Chest. 2007;131(1):2-5.

Loss SH, Marchese CB, Boniatti MM, Wawrzeniak IC, Oliveira RP, Nunes LN, Victorino JA. Prediction of chronic critical illness in a general intensive care unit. Rev Assoc Med Bras. (1992) 2013;59(3):241-7.

Griffiths J, Barber VS, Morgan L, Young JD. Systematic review and metaanalysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation. Bmj. 2005;330(7502):1243.

Combes A, Luyt CE, Nieszkowska A, Trouillet JL, Gibert C, Chastre J. Is tracheostomy associated with better outcomes for patients requiring longterm mechanical ventilation? Crit Care Med. 2007;35(3):802-7.

Chazan B, Raz R, Teitler N, Nitzan O, Edelstein H, Colodner R. Epidemiology and susceptibility to antimicrobials in community, hospital and long-term care facility bacteremia in northern Israel: a 6 year surveillance. Isr Med Assoc J. 2009;11(10):592-7.

Nicolle L, McIntyre M, Hoban D, Murray D. Bacteremia in a long term care facility. Can J Infect Dis. 1994;5(3):130-2.

Ko HK, Yu WK, Lien TC, Wang JH, Slutsky AS, Zhang H, Kou YR. Intensive care unit-acquired bacteremia in mechanically ventilated patients: clinical features and outcomes. PLoS One. 2013;8(12):e83298.

Leistner R, Sakellariou C, Gurntke S, Kola A, Steinmetz I, Kohler C, Pfeifer Y, Eller C, Gastmeier P, Schwab F. Mortality and molecular epidemiology associated with extended-spectrum beta-lactamase production in Escherichia coli from bloodstream infection. Infect Drug Resist. 2014;7:57-62.

March A, Aschbacher R, Dhanji H,Livermore DM, Böttcher A, Sleghel F, Maggi S, Noale M, Larcher C, Woodford N. Colonization of residents and staff of a long-term-care facility and adjacent acute-care hospital geriatric unit by multiresistant bacteria. Clin Microbiol Infect .2010;16(7):934-44.

Barnett AG, Page K, Campbell M, Martin E, Rashleigh-Rolls R, Halton K, Paterson DL, Hall L, Jimmieson N, White K, Graves N. The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections: a case-control study. BMJ Open. 2013;3(10):e003587.

Kelly A, Conell-Price J, Covinsky K, Cenzer IS, Chang A, Boscardin WJ, Smith AK. Length of stay for older adults residing in nursing homes at the end of life. J Am Geriatr Soc 2010;58(9):1701-6.

Lew CC, Yandell R, Fraser RJL, Chua AP, Chong MFF, Miller M. Association Between Malnutrition and Clinical Outcomes in the Intensive Care Unit: A Systematic Review. JPEN J Parenter Enteral Nutr. 2017;(5):744-58.

Singh N, Gupta D, Aggarwal AN, Agarwal R, Jindal SK. An assessment of nutritional support to critically ill patients and its correlation with outcomes in a respiratory intensive care unit. Respir Care. 2009;54(12):1688-96.

Correia MI, Waitzberg DL: The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22(3):235-9.