Comparison of clinical characteristics and outcomes between homeless and non-homeless patients admitted to intensive care units

An observational propensity-matched cohort study in Korea

Ye Jin Lee, Seo Young Yun, Jung Kyu Lee, Eun Young Heo, Deog Kyeom Kim, Hee Soon Chung, Tae Yun Park

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To compare clinical characteristics and outcomes between critically ill homeless and non-homeless patients admitted to the intensive care unit (ICU) in a Korea. Materials and methods: We retrospectively analyzed the medical charts of homeless and non-homeless patients admitted to ICU at Seoul Boramae Medical Center between January 2012 and December 2017. Patients were selected using 1: 2 propensity score matching including age, sex, and type of ICU and multivariate analyses were performed to determine risk factors for hospital and ICU mortality. Results: 56 homeless and 112 non-homeless matched patients were analyzed. The homeless patients were younger, included more men, and exhibited significantly higher readmission and ER admission rates. Although hospital and ICU mortality rates were similar between two groups, the homeless patients were significantly less likely to have family or substitute decision-makers and generally died after cardiopulmonary resuscitation. Adjusted multivariate analysis showed that homelessness was not an independent predictor of ICU or hospital mortality. The length of ICU stay was comparable between groups. Conclusions: In Korea, ICU-admitted homeless patients are well managed without differences in terms of organ support quality and exhibit the same prognosis as non-homeless patients. However, the quality of end-of-life care for homeless patients remains poor.

Original languageEnglish
Pages (from-to)80-85
Number of pages6
JournalJournal of Critical Care
Volume52
DOIs
StatePublished - 1 Aug 2019

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Korea
Intensive Care Units
Cohort Studies
Multivariate Analysis
Homeless Persons
Propensity Score
Terminal Care
Mortality
Cardiopulmonary Resuscitation
Hospital Mortality
Critical Illness
Quality of Life

Keywords

  • Critical care
  • Homeless
  • Intensive care unit
  • Mortality
  • Propensity score matching

Cite this

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title = "Comparison of clinical characteristics and outcomes between homeless and non-homeless patients admitted to intensive care units: An observational propensity-matched cohort study in Korea",
abstract = "Purpose: To compare clinical characteristics and outcomes between critically ill homeless and non-homeless patients admitted to the intensive care unit (ICU) in a Korea. Materials and methods: We retrospectively analyzed the medical charts of homeless and non-homeless patients admitted to ICU at Seoul Boramae Medical Center between January 2012 and December 2017. Patients were selected using 1: 2 propensity score matching including age, sex, and type of ICU and multivariate analyses were performed to determine risk factors for hospital and ICU mortality. Results: 56 homeless and 112 non-homeless matched patients were analyzed. The homeless patients were younger, included more men, and exhibited significantly higher readmission and ER admission rates. Although hospital and ICU mortality rates were similar between two groups, the homeless patients were significantly less likely to have family or substitute decision-makers and generally died after cardiopulmonary resuscitation. Adjusted multivariate analysis showed that homelessness was not an independent predictor of ICU or hospital mortality. The length of ICU stay was comparable between groups. Conclusions: In Korea, ICU-admitted homeless patients are well managed without differences in terms of organ support quality and exhibit the same prognosis as non-homeless patients. However, the quality of end-of-life care for homeless patients remains poor.",
keywords = "Critical care, Homeless, Intensive care unit, Mortality, Propensity score matching",
author = "Lee, {Ye Jin} and Yun, {Seo Young} and Lee, {Jung Kyu} and Heo, {Eun Young} and Kim, {Deog Kyeom} and Chung, {Hee Soon} and Park, {Tae Yun}",
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T1 - Comparison of clinical characteristics and outcomes between homeless and non-homeless patients admitted to intensive care units

T2 - An observational propensity-matched cohort study in Korea

AU - Lee, Ye Jin

AU - Yun, Seo Young

AU - Lee, Jung Kyu

AU - Heo, Eun Young

AU - Kim, Deog Kyeom

AU - Chung, Hee Soon

AU - Park, Tae Yun

N1 - Copyright © 2019. Published by Elsevier Inc.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Purpose: To compare clinical characteristics and outcomes between critically ill homeless and non-homeless patients admitted to the intensive care unit (ICU) in a Korea. Materials and methods: We retrospectively analyzed the medical charts of homeless and non-homeless patients admitted to ICU at Seoul Boramae Medical Center between January 2012 and December 2017. Patients were selected using 1: 2 propensity score matching including age, sex, and type of ICU and multivariate analyses were performed to determine risk factors for hospital and ICU mortality. Results: 56 homeless and 112 non-homeless matched patients were analyzed. The homeless patients were younger, included more men, and exhibited significantly higher readmission and ER admission rates. Although hospital and ICU mortality rates were similar between two groups, the homeless patients were significantly less likely to have family or substitute decision-makers and generally died after cardiopulmonary resuscitation. Adjusted multivariate analysis showed that homelessness was not an independent predictor of ICU or hospital mortality. The length of ICU stay was comparable between groups. Conclusions: In Korea, ICU-admitted homeless patients are well managed without differences in terms of organ support quality and exhibit the same prognosis as non-homeless patients. However, the quality of end-of-life care for homeless patients remains poor.

AB - Purpose: To compare clinical characteristics and outcomes between critically ill homeless and non-homeless patients admitted to the intensive care unit (ICU) in a Korea. Materials and methods: We retrospectively analyzed the medical charts of homeless and non-homeless patients admitted to ICU at Seoul Boramae Medical Center between January 2012 and December 2017. Patients were selected using 1: 2 propensity score matching including age, sex, and type of ICU and multivariate analyses were performed to determine risk factors for hospital and ICU mortality. Results: 56 homeless and 112 non-homeless matched patients were analyzed. The homeless patients were younger, included more men, and exhibited significantly higher readmission and ER admission rates. Although hospital and ICU mortality rates were similar between two groups, the homeless patients were significantly less likely to have family or substitute decision-makers and generally died after cardiopulmonary resuscitation. Adjusted multivariate analysis showed that homelessness was not an independent predictor of ICU or hospital mortality. The length of ICU stay was comparable between groups. Conclusions: In Korea, ICU-admitted homeless patients are well managed without differences in terms of organ support quality and exhibit the same prognosis as non-homeless patients. However, the quality of end-of-life care for homeless patients remains poor.

KW - Critical care

KW - Homeless

KW - Intensive care unit

KW - Mortality

KW - Propensity score matching

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