Introduction:
Economic evaluations of interventions in the hospital setting often rely on the estimated long-term
impact on patient survival. Estimates of mortality rates and long-term outcomes among patients discharged alive
from the intensive care unit (ICU) are lacking from lower- and middle-income countries. This study aimed to assess
the long-term survival and life expectancy (LE) amongst post-ICU patients in Thailand, a middle-income country.
Methods:
In this retrospective cohort study, data from a regional tertiary hospital in northeast Thailand and the
regional death registry were linked and used to assess patient survival time after ICU discharge. Adult ICU patients
aged at least 15 years who had been discharged alive from an ICU between 1 January 2004 and 31 December 2005
were included in the study, and the death registry was used to determine deaths occurring in this cohort up to
31
st
December 2010. These data were used in conjunction with standard mortality life tables to estimate annual
mortality and life expectancy.
Results:
This analysis included 10,321 ICU patients. During ICU admission, 3,251 patients (31.5%) died. Of 7,070
patients discharged alive, 2,527 (35.7%) were known to have died within the five-year follow-up period, a mortality
rate 2.5 times higher than that in the Thai general population (age and sex matched). The mean LE was estimated
as 18.3 years compared with 25.2 years in the general population.
Conclusions:
Post-ICU patients experienced much higher rates of mortality than members of the general
population over the five-year follow-up period, particularly in the first year after discharge. Further work assessing
Health Related Quality of Life (HRQOL) in both post-ICU patients and in the general population in developing
countries is needed.