Characteristics, clinical course, and outcomes of homeless and non-homeless patients admitted to ICU: A retrospective cohort study

by Orla M. Smith, Clarence Chant, Karen E. A. Burns, Maninder Kaur, Said Ashraf, Claudia C. DosSantos, Stephen W. Hwang, Jan O. Friedrich

Background

Little is known about homeless patients in intensive care units (ICUs).

Objectives

To compare clinical characteristics, treatments, and outcomes of homeless to non-homeless patients admitted to four ICUs in a large inner-city academic hospital.

Methods

63 randomly-selected homeless compared to 63 age-, sex-, and admitting-ICU-matched non-homeless patients.

Results

Compared to matched non-homeless, homeless patients (average age 48±12 years, 90% male, 87% admitted by ambulance, 56% mechanically ventilated, average APACHE II 17) had similar comorbidities and illness severity except for increased alcohol (70% vs 17%,p Conclusions

Homeless patients, admitted to ICU matched to non-homeless patients by age and sex (characteristics most commonly used by clinicians), have higher hospital mortality despite similar comorbidities and illness severity. Trends to longer durations of life supports may have contributed to the higher mortality. Additional research is required to validate this higher mortality and develop strategies to improve outcomes in this vulnerable population.

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