• Liran Statlender, Tzippy Shochat, Eyal Robinson, Guy Fishman, Moran Hellerman-Itzhaki, Itai Bendavid, Pierre Singer, and Ilya Kagan.
• Department of General Intensive Care, Rabin Medical Centre, Beilinson Hospital, Petah Tikva, Israel; School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: liranst1@clalit.org.il.
• J Crit Care. 2024 Oct 1; 83: 154834154834.

IntroductionPersistent critical illness (PCI) is a syndrome in which the acute presenting problem has been stabilized, but the patient's clinical state does not allow ICU discharge. The burden associated with PCI is substantial. The most obvious marker of PCI is prolonged ICU length of stay (LOS), usually greater than 10 days. Urea to Creatinine ratio (UCr) has been suggested as an early marker of PCI development.MethodsA single-center retrospective study. Data of patients admitted to a general mixed medical-surgical ICU during Jan 1st 2018 till Dec 31st 2022 was extracted, including demographic data, baseline characteristics, daily urea and creatinine results, renal replacement therapy (RRT) provided, and outcome measures - length of stay, and mortality (ICU, and 90 days). Patients were defined as PCI patients if their LOS was >10 days. We used Fisher exact test or Chi-square to compare PCI and non-PCI patients. The association between UCr with PCI development was assessed by repeated measures linear model. Multivariate Cox regression was used for 1 year mortality assessment.Results2098 patients were included in the analysis. Patients who suffered from PCI were older, with higher admission prognostic scores. Their 90-day mortality was significantly higher than non-PCI patients (34.58% vs 12.18%, p < 0.0001). A significant difference in UCr was found only on the first admission day among all patients. This was not found when examining separately surgical, trauma, or transplantation patients. We did not find a difference in UCr in different KDIGO (Kidney Disease Improving Global Outcomes) stages. Elevated UCr and PCI were found to be significantly associated with 1 year mortality.ConclusionIn this single center retrospective cohort study, UCr was not found to be associated with PCI development.Copyright © 2023. Published by Elsevier Inc.

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