Twenty-eight–day mortality in critically ill surgical patients is an imprecise temporal end-point measure for in-hospital mortality

Background The purpose of this study was to determine the incidence of deaths occurring beyond 28 days in critically ill surgical patients and to identify the proportion of these deaths attributable to the original disease process. Methods Analysis of 1,360 subjects admitted to a surgical intensive care unit during a 2 year period. Demographics, indication(s) for admission, comorbidities, mortality rate, multiorgan failure development, and cause of death was obtained. Results Mortality rate in the surgical intensive care unit was 12%. Twenty % of deaths occurred more than 28 days after hospital admission with 76% of deaths related to admission diagnosis. By day 34, 95% of mortalities had occurred. Conclusions The 28-day time period used to assess efficacy of therapeutic interventions and to define mortality in the context of quality audits should be questioned. If these findings are validated in other centers another temporal end point for in-hospital mortality should be considered.