Purpose

Whether undocumented migrants admitted to intensive care units (ICUs) have specific features is unknown. We aimed to determine the features and outcomes of undocumented migrants admitted to French ICUs.

Methods

We retrospectively included all undocumented adult migrants admitted in 2011–2018 and compared them to the general ICU population. We also compared these two groups matched on age, sex, severity, comorbidities, reason for ICU admission and public/private hospital.

Results

We identified 14,554 ICU stays, with an increase from 2 to 4‰ of all ICU admissions over time. Shock (16.7%), post-operative care (13.8%), and trauma (10.5%) were the main reasons for ICU admission. Compared to general ICU patients, migrants were younger and had greater disease severity. After adjustment on age and sex, the following were more common in migrants: shock (OR 1.2 [1.14–1.25]; P < 0.0001), infections (1.48 [1.38–1.54]; P < 0.001), acute respiratory failure (1.09 [1.03–1.15]; P = 0.006), acute kidney injury (1.12 [1.05–1.19]; P < 0.001), obstetric events (1.53 [1.66–1.81]; P < 0.0001), and neurological deficits (1.19 [1.12–1.27]; P < 0.0001). In the matched study, migrants more often required vasopressors, mechanical ventilation, and renal replacement therapy; had longer ICU stays (median 4 [2–8] vs. 4 [2–7] days; P < 0.0001) and hospital stays (10 [5–20] vs. 8 [4–15]; P < 0.0001) and had higher hospital costs (14.2 ± 23.6 vs. 13.4 ± 11.5 K€; P < 0.0001). Hospital mortality was similar (6.7% vs. 6.6%; P = 0.69).

Conclusion

Admissions of undocumented migrants to French ICUs doubled from 2011 to 2018. The patients were younger and, although sicker, achieved similar outcomes to those in general ICU patients.

中文翻译：

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2011-2018 年法国重症监护病房的无证移民：全国回顾性研究

目的

入住重症监护病房 (ICU) 的无证移民是否具有特定特征尚不清楚。我们旨在确定法国 ICU 收治的无证移民的特征和结果。

方法

我们回顾性地纳入了 2011-2018 年收治的所有无证成年移民，并将他们与一般 ICU 人口进行了比较。我们还比较了这两组在年龄、性别、严重程度、合并症、入住 ICU 的原因和公立/私立医院方面的匹配情况。

结果

我们确定了 14,554 次 ICU 住院，随着时间的推移，所有 ICU 住院人数的比例从 2‰ 增加到 4‰。休克（16.7%）、术后护理（13.8%）和外伤（10.5%）是入住ICU的主要原因。与普通 ICU 患者相比，流动人口更年轻，疾病严重程度更高。调整年龄和性别后，以下在流动人口中更常见：休克（OR 1.2 [1.14-1.25]；P  < 0.0001）、感染（1.48 [1.38-1.54]；P  < 0.001）、急性呼吸衰竭（1.09 [ ... 1.03–1.15]；P  = 0.006)、急性肾损伤（1.12 [1.05–1.19]；P  < 0.001）、产科事件（1.53 [1.66–1.81]；P  < 0.0001）和神经功能缺损（1.19 [1.12–1.27） ]; P < 0.0001)。在匹配研究中，移民更经常需要血管加压药、机械通气和肾脏替代治疗；ICU 住院时间更长（中位数 4 [2-8] 对 4 [2-7] 天；P  < 0.0001）和住院时间（10 [5-20] 对 8 [4-15]；P  < 0.0001）和住院费用较高（14.2 ± 23.6 对 13.4 ± 11.5 K€；P  < 0.0001）。住院死亡率相似（6.7% 对 6.6%；P  = 0.69）。

结论

从 2011 年到 2018 年，法国 ICU 的无证移民收治人数翻了一番。患者更年轻，虽然病情更严重，但与普通 ICU 患者的结果相似。