CoChat
Sign Up
Cited by 420Sepsis Diagnosis and TreatmentGlobal Health and EpidemiologyNosocomial Infections in ICU

The Epidemiology of Chronic Critical Illness in the United States*

Open access
Kahn, Jeremy M., Le, Tri, Angus, Derek C., Cox, Christopher E., Hough, Catherine L., White, Douglas B., Yende, Sachin, Carson, Shannon S.·2015·Critical Care Medicine
DOI 10.1097/ccm.0000000000000710PMC PMC7901538
Open this paper in CoChat — free account

Abstract

OBJECTIVES: The epidemiology of chronic critical illness is not well characterized. We sought to determine the prevalence, outcomes, and associated costs of chronic critical illness in the United States. DESIGN: Population-based cohort study using data from the United States Healthcare Costs and Utilization Project from 2004 to 2009. SETTING: Acute care hospitals in Massachusetts, North Carolina, Nebraska, New York, and Washington. PATIENTS: Adult and pediatric patients meeting a consensus-derived definition for chronic critical illness, which included one of six eligible clinical conditions (prolonged acute mechanical ventilation, tracheotomy, stroke, traumatic brain injury, sepsis, or severe wounds) plus at least 8 days in an ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Out of 3,235,741 admissions to an ICU during the study period, 246,151 (7.6%) met the consensus definition for chronic critical illness. The most common eligibility conditions were prolonged acute mechanical ventilation (72.0% of eligible admissions) and sepsis (63.7% of eligible admissions). Among patients meeting chronic critical illness criteria through sepsis, the infections were community acquired in 48.5% and hospital acquired in 51.5%. In-hospital mortality was 30.9% with little change over the study period. The overall population-based prevalence was 34.4 per 100,000. The prevalence varied substantially with age, peaking at 82.1 per 100,000 individuals 75-79 years old but then declining coincident with a rise in mortality before day 8 in otherwise eligible patients. Extrapolating to the entire United States, for 2009, we estimated a total of 380,001 cases; 107,880 in-hospital deaths and $26 billion in hospital-related costs. CONCLUSIONS: Using a consensus-based definition, the prevalence, hospital mortality, and costs of chronic critical illness are substantial. Chronic critical illness is particularly common in the elderly although in very old patients the prevalence declines, in part because of an increase in early mortality among potentially eligible patients.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/ccm.0000000000000710

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Prolonged mechanical ventilation is associated with high mortality, functional and cognitive disability, caregiver burden, and health care costs exceeding $35 billion.

    “is associated with high mortality, functional and cognitive disability, caregiver burden, and health care costs exceeding $35 billion (1, 2).”

    From Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation (2019) · cites this paper as [2]

    The Results report 30.9% in-hospital mortality among patients with chronic critical illness, 72% of whom had prolonged acute mechanical ventilation; the Discussion identifies neuromuscular weakness and neurocognitive dysfunction as hallmarks of the syndrome. But the paper does not report caregiver burden, and its Discussion estimates costs for chronic critical illness at closer to $35 billion—not exceeding $35 billion for prolonged mechanical ventilation specifically. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Prolonged mechanical ventilation affects 400,000 U.S. patients annually.

    “Prolonged mechanical ventilation affects 400 000 U.S. patients annually”

    From Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation (2019) · cites this paper as [2]

    The Abstract’s Measurements and Main Results estimate 380,001 U.S. cases of chronic critical illness in 2009, approximately 400,000. But prolonged acute mechanical ventilation was an eligibility condition in 72.0% of those cases; the paper does not identify the 380,001 cases as patients receiving prolonged mechanical ventilation. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [26]White DB, Braddock CH, Bereknyei S,: Toward shared decision making at the end of life in intensive care units: opportunities for improvement. Arch. Intern. Med 2007; 167: 461– 467 17353493

Cited by

Sorted by citations

Related

Authors
Kahn, J. M., Le, T., Angus, D. C., Cox, C. E., Hough, C. L., White, D. B., Yende, S., & Carson, S. S.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • University of Pittsburgh (US)
  • Duke University (US)
  • University of Washington (US)
ORCID
Venue
Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-02
Volume
43
Issue
2
Pages
282-287
ISSN
0090-3493 (ISSN-L)
DOI
10.1097/ccm.0000000000000710
PMC
PMC7901538
OpenAlex
W2063094401
Cited by
420
References
32
Citations by year
2026: 33 · 2025: 33 · 2024: 38 · 2023: 40 · 2022: 42 · 2021: 45 · 2020: 39 · 2019: 42 · 2018: 21 · 2017: 36 · 2016: 30 · 2015: 21
FWCI
21.91
Type
journal article
Language
en
Open access
Locations
  • Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Heart, Lung, and Blood Institute (R01HL096651)
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Health Professions › Health Information Management › Global Health and Epidemiology
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Keywords
chronic critical illness, prolonged mechanical ventilation, sepsis, intensive care unit admission, prevalence, in-hospital mortality, health care costs, community-acquired infections, nosocomial infections, elderly patients, pediatric patients, acute respiratory failure, traumatic brain injury, stroke
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Chronic Disease, Costs and Cost Analysis, Cross Infection, Female, Hospital Bed Capacity, Humans, Infant, Intensive Care Units, Length of Stay, Long-Term Care, Male, Middle Aged, Respiration, Artificial, United States, Prevalence, Critical Illness, Treatment Outcome, Hospital Mortality, Age Distribution, Sex Distribution, Community-Acquired Infections, Sepsis, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review