Early mortality in critical illness – A descriptive analysis of patients who died within 24 hours of ICU admission

Abstract Purpose To describe patients who die within 24 h of ICU admission in order to better optimize care delivery. Methods This was a retrospective cohort study of patients ≥18 years old admitted to 17 adult ICUs in Alberta, Canada from January 1, 2016 and June 30, 2017. Data were obtained from a provincial clinical information system and data repository. The primary outcome was incidence of ICU death within 24 h of admission. Secondary outcomes were patient and system factors associated with early death. Variables of interest were identified a priori and examined using multivariable logistic regression. Results Of 19,556 patients admitted to ICU in an 18-month period, 3.3% died within 24 h, representing 29.8% of ICU deaths. Factors associated with early death were age (adjusted-OR 0.99, 95% CI, 0.9–1.0), acuity (adjusted-OR 1.3, 95% CI, 1.3–1.4), admission from the Emergency Department (ED; adjusted-OR 1.5, 95% CI, 1.1–1.9) and surgical (adjusted-OR 2.27, 95% CI, 1.4–3.6), neurologic (adjusted-OR 4.6, 95% CI, 3.1–6.9) or trauma diagnosis (adjusted-OR 6.1, 95% CI, 2.4–15.6). Conclusion Patients who die within 24 h constitute one third of ICU deaths. Age, acuity, admission from the ED and surgical, neurologic or trauma-related admission diagnosis correlate with early death.