• Peter R Hicks and Diane M Mackle.
• Intensive Care Unit, Wellington Hospital, Wellington, New Zealand. Peter.hicks@ccdhb.org.nz
• Crit Care Resusc. 2010 Jun 1;12(2):78-82.

ObjectiveTo identify intensive care patients dying within 2 years of discharge from hospital and assess whether the cause of death was related to the diagnosis at hospital discharge.Design, Setting And ParticipantsA retrospective cohort study of all patients admitted to the intensive care unit at Wellington Hospital, New Zealand, between 1 July 2001 and 30 June 2003, using data from the ICU database. Mortality data were obtained from the New Zealand National Death Registry.Main Outcome MeasuresDeath within 2 years of hospital discharge; cause of death and its relation to the hospital discharge diagnosis.ResultsOf 1984 patients discharged home, 193 died within 2 years. One-year and 2-year survival rates were 93.8% and 90.3%, respectively. Two-year mortality rates were 4.6% in elective cardiac surgical patients, 19.7% in elective noncardiac surgical patients, 16.9% in acute patients admitted from the operating room, and 10.2% in other acute patients. Among the 193 patients who died after discharge, 124 deaths (64.2%) were related to the diagnosis at hospital discharge. The mortality rate in this group was highest at 3 months (90.5%) and lower at 6 months (75.0%), then averaged 51.4% after 6 months. Cause of death was related to discharge diagnosis in 46.2% of elective cardiac surgical patients, 66.6% of elective non-cardiac surgical patients, 60.5% of acute patients admitted from the operating room, and 75.4% of other acute patients. Cancer was the cause of death in 34.2% of elective cardiac surgical patients, 66.7% of elective non-cardiac surgical patients, 48.8% of acute patients admitted from the operating room, and 29.0% of other acute patients.ConclusionSurvival rates of ICU patients after discharge from hospital are high. Deaths are closely related to the discharge diagnosis only in the first 6 months after discharge. Cancer is a common cause of death. Elective non-cardiac surgical patients have the worst outcomes.

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