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Management and outc...
Management and outcomes in critically ill nonagenarian versus octogenarian patients
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- Bruno, Raphael Romano (author)
- Heinrich Heine Univ Duesseldorf, Germany
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- Wernly, Bernhard (author)
- Paracelsus Med Univ, Austria; Karolinska Univ Hosp, Sweden
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- Kelm, Malte (author)
- Heinrich Heine Univ Duesseldorf, Germany; Cardiovasc Res Inst Dusseldorf, Germany
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- Boumendil, Ariane (author)
- St Hop Paris, France
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- Morandi, Alessandro (author)
- Dept Rehabil Hosp Ancelle Cremona, Italy; Geriatr Res Grp, Italy
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- Andersen, Finn H. (author)
- Alesund Hosp, Norway; NTNU, Norway
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- Artigas, Antonio (author)
- CIBERes Corporac Sanitaria Univ Parc Tau, Spain
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- Finazzi, Stefano (author)
- Ist Ric Farmacol Mario Negri IRCCS, Italy
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- Cecconi, Maurizio (author)
- Humanitas Univ, Italy
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- Christensen, Steffen (author)
- Aarhus Univ Hosp, Denmark
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- Faraldi, Loredana (author)
- Grande Osped Metropolitano Niguarda, Italy
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- Lichtenauer, Michael (author)
- Paracelsus Med Univ, Austria
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- Muessig, Johanna M. (author)
- Heinrich Heine Univ Duesseldorf, Germany
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- Marsh, Brian (author)
- Mater Misericordiae Univ Hosp, Ireland
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- Moreno, Rui (author)
- Univ Lisboa Cent, Portugal
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- Oeyen, Sandra (author)
- 1K12 Ghent Univ Hosp, Belgium
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- ohman, Christina Agvald (author)
- Karolinska Univ Hosp, Sweden
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- Pinto, Bernardo Bollen (author)
- Geneva Univ Hospitals, Switzerland
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- Soliman, Ivo W. (author)
- Univ Utrecht, Netherlands
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- Szczeklik, Wojciech (author)
- Jagiellonian Univ, Poland
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- Valentin, Andreas (author)
- Kardinal Schwarzenberg Hosp, Austria
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- Watson, Ximena (author)
- St Georges Univ Hosp, England
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- Leaver, Susannah (author)
- Res Lead Critical Care Directorate St Georges Hos, England
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- Boulanger, Carole (author)
- Royal Devon & Exeter NHS Fdn Trust, England
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- Walther, Sten (author)
- Region Östergötland, Thorax-kärlkliniken i Östergötland
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- Schefold, Joerg C. (author)
- Univ Bern, Switzerland
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- Joannidis, Michael (author)
- Med Univ Innsbruck, Austria
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- Nalapko, Yuriy (author)
- ICU, Ukraine
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- Elhadi, Muhammed (author)
- Alkhums Hosp, Libya
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- Fjolner, Jesper (author)
- Aarhus Univ Hosp, Denmark
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- Zafeiridis, Tilemachos (author)
- Gen Hosp Larissa, Greece
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- De Lange, Dylan W. (author)
- Univ Utrecht, Netherlands
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- Guidet, Bertrand (author)
- St Hop Paris, France; Sorbonne Univ, France; INSERM, France
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- Flaatten, Hans (author)
- Univ Bergen, Norway; Haukeland Hosp, Norway
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- Jung, Christian (author)
- Heinrich Heine Univ Duesseldorf, Germany
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(creator_code:org_t)
- 2021-10-19
- 2021
- English.
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In: BMC Geriatrics. - : BMC. - 1471-2318. ; 21:1
- Related links:
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https://liu.diva-por... (primary) (Raw object)
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https://bmcgeriatr.b...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
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- Background: Intensive care unit (ICU) patients age 90 years or older represent a growing subgroup and place a huge financial burden on health care resources despite the benefit being unclear. This leads to ethical problems. The present investigation assessed the differences in outcome between nonagenarian and octogenarian ICU patients. Methods: We included 7900 acutely admitted older critically ill patients from two large, multinational studies. The primary outcome was 30-day-mortality, and the secondary outcome was ICU-mortality. Baseline characteristics consisted of frailty assessed by the Clinical Frailty Scale (CFS), ICU-management, and outcomes were compared between octogenarian (80-89.9 years) and nonagenarian (>= 90 years) patients. We used multilevel logistic regression to evaluate differences between octogenarians and nonagenarians. Results: The nonagenarians were 10% of the entire cohort. They experienced a higher percentage of frailty (58% vs 42%; p < 0.001), but lower SOFA scores at admission (6 +/- 5 vs. 7 +/- 6; p < 0.001). ICU-management strategies were different. Octogenarians required higher rates of organ support and nonagenarians received higher rates of life-sustaining treatment limitations (40% vs. 33%; p < 0.001). ICU mortality was comparable (27% vs. 27%; p = 0.973) but a higher 30-day-mortality (45% vs. 40%; p = 0.029) was seen in the nonagenarians. After multivariable adjustment nonagenarians had no significantly increased risk for 30-day-mortality (aOR 1.25 (95% CI 0.90-1.74; p = 0.19)). Conclusion: After adjustment for confounders, nonagenarians demonstrated no higher 30-day mortality than octogenarian patients. In this study, being age 90 years or more is no particular risk factor for an adverse outcome. This should be considered- together with illness severity and pre-existing functional capacity - to effectively guide triage decisions.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
Keyword
- Octogenarians; Nonagenarians; Frailty; Intensive care medicine; Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Bruno, Raphael R ...
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Wernly, Bernhard
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Kelm, Malte
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Boumendil, Arian ...
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Morandi, Alessan ...
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Andersen, Finn H ...
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show more...
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Artigas, Antonio
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Finazzi, Stefano
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Cecconi, Maurizi ...
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Christensen, Ste ...
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Faraldi, Loredan ...
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Lichtenauer, Mic ...
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Muessig, Johanna ...
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Marsh, Brian
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Moreno, Rui
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Oeyen, Sandra
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ohman, Christina ...
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Pinto, Bernardo ...
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Soliman, Ivo W.
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Szczeklik, Wojci ...
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Valentin, Andrea ...
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Watson, Ximena
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Leaver, Susannah
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Boulanger, Carol ...
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Walther, Sten
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Schefold, Joerg ...
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Joannidis, Micha ...
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Nalapko, Yuriy
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Elhadi, Muhammed
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Fjolner, Jesper
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Zafeiridis, Tile ...
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De Lange, Dylan ...
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Guidet, Bertrand
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Flaatten, Hans
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Jung, Christian
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Nursing
- Articles in the publication
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BMC Geriatrics
- By the university
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Linköping University
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Karolinska Institutet