Intensive Care (ICU)NCT07571213
Pre-ICU Hospital Length of Stay and 30-day Mortality in the Very Old: a National Cohort of 315 042 ICU Admissions
An observational study of Intensive Care (ICU) and Age Over 80 Years, run by Uppsala University at 1 site in Sweden.
Trial summary
How does waiting in hospital before intensive care affect older patients?Patients who become seriously ill are sometimes admitted to a regular hospital ward first, and only transferred to the intensive care unit (ICU) when their condition worsens. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Intensive Care (ICU), Age Over 80 Years, Hospital Length of Stay
- What is being tested?
- Time in hospital before ICU admission.
- How many people
- 315,042 participants
- Where
- 1 siteSweden
- Study dates
- 30 Sep 2019to 30 Sep 2019
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patient admitted to a Swedish ICU that reported the admission to the Swedish intensive care registry.
Who may be able to join
- Patient admitted to a Swedish ICU that reported the admission to the Swedish intensive care registry.
Who cannot join
- -
Trial locations and contacts
1 site in 1 country.
About this study
How does waiting in hospital before intensive care affect older patients?Patients who become seriously ill are sometimes admitted to a regular hospital ward first, and only transferred to the intensive care unit (ICU) when their condition worsens. The longer this wait, the higher the risk of dying within the following weeks. The number of very old patients (aged 80 and over) considered for ICU care is rising, and decisions about whether and when to admit them are difficult. It is not known whether the wait before ICU matters as much in this age group as in younger patients, or whether it carries different weight when judging how serious their illness is. Over 315,000 adults admitted to Swedish ICUs between 2005 and 2016 were examined, and statistical models were used to estimate how the risk of dying within 30 days depends on age and on the time spent in hospital before reaching the ICU.
Read the detailed description
Background. Hospital length of stay before intensive care unit (ICU) admission (pre-ICU LOS) is an established prognostic marker for short-term mortality in critically ill patients: longer pre-ICU stays are generally associated with higher subsequent mortality. Whether this association holds uniformly across the adult age range, or is modified by age, is not established. The question is clinically relevant for the very old (≥80 years), an increasing share of ICU populations, in whom triage decisions are particularly consequential. How age modifies the association between pre-ICU LOS and 30-day mortality will be examined in a national cohort of adult ICU patients.
Design and setting. A retrospective cohort study using prospectively collected data from the Swedish Intensive Care Registry (SIR) linked to the Swedish National Patient Registry (NPR) and the Swedish Cause of Death Registry. The study will include all adult (≥18 years) first ICU admissions reported to SIR between 1 January 2005 and 31 December 2016. Records will be linked across registries via the Swedish personal identification number; patients without a valid number are excluded by the data holders before delivery. The study has been approved by the Regional Ethics Committee of Uppsala (DNR 2016/421), which also waived informed consent.
Exposure. Pre-ICU LOS is the time in hospital between hospital and ICU admission, with zero for direct-from-emergency-department admissions. Where missing, pre-ICU LOS will be reconstructed from NPR care episodes adjacent to the ICU episode.
Outcome. All-cause mortality within 30 days of ICU admission, as a binary endpoint. Follow-up is complete by registry design.
Analysis. The primary analysis will be a binary logistic regression on 30-day mortality, allowing for non-linear effects of age, pre-ICU LOS, and the Quan-updated Charlson comorbidity index, with sex as a binary factor. Pairwise interactions between age and pre-ICU LOS, pre-ICU LOS and sex, and age and sex will be included. The adjustment set is chosen a priori from a directed acyclic graph; acute physiology at admission (SAPS3 Box III) is excluded as a plausible post-exposure mediator. Marginal predicted 30-day mortality and within- and between-age risk differences will be estimated by G-computation at a range of clinically meaningful pre-ICU LOS values across age deciles. Uncertainty will be quantified by nonparametric bootstrap with percentile 95 % confidence intervals. Sensitivity analyses will examine the primary findings under categorical specifications of age and pre-ICU LOS, and after adjustment for SAPS3 Box III with multiple imputation of missing values.
- Being tested
- Time in hospital before ICU admission.
- Keywords
- Age, icu, hospital lenght of stay, 30-day mortality, risk factor
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Time in hospital before ICU admission.Other
Time in hospital before ICU admission by age groups.
| Study group | Role | What they receive |
|---|---|---|
| Patients admitted to Swedish ICUs | Patients admitted to Swedish ICUs between 2005 and 2017 Receives: Other: Time in hospital before ICU admission. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mortality
Measured: 30 day
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 May 2026
- Study start30 Sep 2019
- Primary completion30 Sep 2019
- Study completion30 Sep 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Intensive Care (ICU)Studies of the same condition, open and under way.
- More trials run by Uppsala UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 315,042 participants (actual)
Sponsor and investigators
- Lead sponsor
- Uppsala University
- Sponsor type
- University, hospital or other
- Collaborators
- Dalarna County Council, Sweden
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07571213
- Sponsor's protocol ID
- Age-length of stay
- Status last verified
- Apr 2026
- First submitted
- 29 Apr 2026
- Last updated
- 6 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: The data is available from the registries according to their rules, that usually involve at least a permission by the Swedish ethical review authority and a fee. The data is also available from the researchers with permission from the Swedish ethical review authority, the Uppsala University and provided that the General data protection act by the European Union is followed.
Publications
Ahlstrom B, Lipcsey M. Pre-ICU hospital length of stay and 30-day mortality in the very old: a national cohort of 315 042 ICU admissions. Ann Intensive Care. 2026 Jul 16;16:100116. doi: 10.1016/j.aicoj.2026.100116. eCollection 2026.
PubMed 42500453
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Pre-ICU Hospital Length of Stay and 30-day Mortality in the Very Old: a National Cohort of 315 042 ICU Admissions
- ClinicalTrials.gov ID
- NCT07571213
- Acronym / sponsor ID
- Age-length of stay
- Keywords
- Age, icu, hospital lenght of stay, 30-day mortality, risk factor
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 315,042 participants (actual)
- Lead sponsor
- Uppsala UniversityUniversity, hospital or other
- Collaborators
- Dalarna County Council, Sweden
- Study start
- 30 Sep 2019 (actual)
- Primary completion
- 30 Sep 2019 (actual)
- Study completion
- 30 Sep 2019 (actual)
- First posted
- 6 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
How does waiting in hospital before intensive care affect older patients?Patients who become seriously ill are sometimes admitted to a regular hospital ward first, and only transferred to the intensive care unit (ICU) when their condition worsens. The longer this wait, the higher the risk of dying within the following weeks. The number of very old patients (aged 80 and over) considered for ICU care is rising, and decisions about whether and when to admit them are difficult. It is not known whether the wait before ICU matters as much in this age group as in younger patients, or whether it carries different weight when judging how serious their illness is. Over 315,000 adults admitted to Swedish ICUs between 2005 and 2016 were examined, and statistical models were used to estimate how the risk of dying within 30 days depends on age and on the time spent in hospital before reaching the ICU.
Detailed description
Background. Hospital length of stay before intensive care unit (ICU) admission (pre-ICU LOS) is an established prognostic marker for short-term mortality in critically ill patients: longer pre-ICU stays are generally associated with higher subsequent mortality. Whether this association holds uniformly across the adult age range, or is modified by age, is not established. The question is clinically relevant for the very old (≥80 years), an increasing share of ICU populations, in whom triage decisions are particularly consequential. How age modifies the association between pre-ICU LOS and 30-day mortality will be examined in a national cohort of adult ICU patients.
Design and setting. A retrospective cohort study using prospectively collected data from the Swedish Intensive Care Registry (SIR) linked to the Swedish National Patient Registry (NPR) and the Swedish Cause of Death Registry. The study will include all adult (≥18 years) first ICU admissions reported to SIR between 1 January 2005 and 31 December 2016. Records will be linked across registries via the Swedish personal identification number; patients without a valid number are excluded by the data holders before delivery. The study has been approved by the Regional Ethics Committee of Uppsala (DNR 2016/421), which also waived informed consent.
Exposure. Pre-ICU LOS is the time in hospital between hospital and ICU admission, with zero for direct-from-emergency-department admissions. Where missing, pre-ICU LOS will be reconstructed from NPR care episodes adjacent to the ICU episode.
Outcome. All-cause mortality within 30 days of ICU admission, as a binary endpoint. Follow-up is complete by registry design.
Analysis. The primary analysis will be a binary logistic regression on 30-day mortality, allowing for non-linear effects of age, pre-ICU LOS, and the Quan-updated Charlson comorbidity index, with sex as a binary factor. Pairwise interactions between age and pre-ICU LOS, pre-ICU LOS and sex, and age and sex will be included. The adjustment set is chosen a priori from a directed acyclic graph; acute physiology at admission (SAPS3 Box III) is excluded as a plausible post-exposure mediator. Marginal predicted 30-day mortality and within- and between-age risk differences will be estimated by G-computation at a range of clinically meaningful pre-ICU LOS values across age deciles. Uncertainty will be quantified by nonparametric bootstrap with percentile 95 % confidence intervals. Sensitivity analyses will examine the primary findings under categorical specifications of age and pre-ICU LOS, and after adjustment for SAPS3 Box III with multiple imputation of missing values.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Patients admitted to Swedish ICUs | – | Other: Time in hospital before ICU admission.Patients admitted to Swedish ICUs between 2005 and 2017 |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patient admitted to a Swedish ICU that reported the admission to the Swedish intensive care registry.
Key inclusion criteria (1 listed)
- Patient admitted to a Swedish ICU that reported the admission to the Swedish intensive care registry.
Key exclusion criteria (1 listed)
- -
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Time in hospital before ICU admission.Time in hospital before ICU admission by age groups. | Other | Patients admitted to Swedish ICUs |
Primary outcome
Mortality
Time frame: 30 day
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 May 2026.
- Derived from this study: PubMed 42500453Ahlstrom B, Lipcsey M. Pre-ICU hospital length of stay and 30-day mortality in the very old: a national cohort of 315 042 ICU admissions. Ann Intensive Care. 2026 Jul 16;16:100116. doi: 10.1016/j.aicoj.2026.100116. eCollection 2026.
- Individual participant dataSharing planned: No. The data is available from the registries according to their rules, that usually involve at least a permission by the Swedish ethical review authority and a fee. The data is also available from the researchers with permission from the Swedish ethical review authority, the Uppsala University and provided that the General data protection act by the European Union is followed.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Intensive Care (ICU) and Age Over 80 Years, run by Uppsala University at 1 site in Sweden.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 6 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mortality (time frame: 30 day). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07571213, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2026.