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Sepsis at ICU admis...
Sepsis at ICU admission does not decrease 30-day survival in very old patients : a post-hoc analysis of the VIP1 multinational cohort study
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- Ibarz, Mercedes (författare)
- Hospital Sagrado Corazon
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- Boumendil, Ariane (författare)
- Assistance Publique des Hôpitaux de Paris
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- Haas, Lenneke E. M. (författare)
- Aarhus University Hospital
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visa fler...
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- Irazabal, Marian (författare)
- Hospital General de Catalunya
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- Flaatten, Hans (författare)
- Haukeland University Hospital
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de Lange, Dylan W. (författare)
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Morandi, Alessandro (författare)
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- Andersen, Finn H. (författare)
- Ålesund Hospital
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Bertolini, Guido (författare)
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Cecconi, Maurizio (författare)
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Christensen, Steffen (författare)
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- Faraldi, Loredana (författare)
- Niguarda Hospital
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Fjølner, Jesper (författare)
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- Jung, Christian (författare)
- Zhongnan Hospital of Wuhan University
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- Marsh, Brian (författare)
- Mater Misericordiae University Hospital
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- Moreno, Rui (författare)
- NOVA University Lisbon
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- Oeyen, Sandra (författare)
- Ghent University Hospital
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- Öhman, Christina Agwald (författare)
- Karolinska Institutet
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- Bollen Pinto, Bernardo (författare)
- Geneva University Hospital
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Soliman, Ivo W. (författare)
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- Szczeklik, Wojciech (författare)
- Jagiellonian University
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- Valentin, Andreas (författare)
- Cardinal Schwarzenberg Hospital
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- Watson, Ximena (författare)
- St George's Hospital, London
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- Zaferidis, Tilemachos (författare)
- University Hospital of Larissa
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Guidet, Bertrand (författare)
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Artigas, Antonio (författare)
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- Brorsson, Camilla (bidragsgivare)
- ICU University Hospital Northern Sweden, Sweden
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- Spångfors, Martin (creator_code:cre_t)
- Central Hospital Kristianstad
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- Bark, Björn (creator_code:cre_t)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cirkulationsfysiologi vid kritisk sjukdom,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Fluid resuscitation in critical illness,Lund University Research Groups,Skåne University Hospital
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- Jungner, Mårten (creator_code:cre_t)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cirkulationsfysiologi vid kritisk sjukdom,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Fluid resuscitation in critical illness,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
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- 2020-05-13
- 2020
- Engelska.
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Ingår i: Annals of Intensive Care. - : Springer. - 2110-5820. ; 10:1
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://annalsofinte...
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http://dx.doi.org/10... (free)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- BACKGROUND: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival.RESULTS: This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81-86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7, p < 0.0001), required more vasoactive drugs [82.2% vs. 55.1%, p < 0.0001] and renal replacement therapies [17.4% vs. 9.9%; p < 0.0001], and had more life-sustaining treatment limitations [37.3% vs. 32.1%; p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86-1.15), p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87-1.17), p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day survival was similar in both groups [57.2% (95% CI 52.7-60.7) vs. 57.1% (95% CI 53.7-60.1), p = 0.85].CONCLUSIONS: After adjusting for organ dysfunction, sepsis at admission was not independently associated with decreased 30-day survival in this multinational study of 3869 VIPs. Age, frailty, and SOFA score were independently associated with survival.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
Nyckelord
- Intensive care
- Mortality
- Outcome
- Sepsis
- Severity of illness
- Survival
- Very old
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Ibarz, Mercedes
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Boumendil, Arian ...
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Haas, Lenneke E. ...
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Irazabal, Marian
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Flaatten, Hans
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de Lange, Dylan ...
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visa fler...
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Morandi, Alessan ...
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Andersen, Finn H ...
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Bertolini, Guido
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Cecconi, Maurizi ...
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Christensen, Ste ...
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Faraldi, Loredan ...
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Fjølner, Jesper
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Jung, Christian
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Marsh, Brian
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Moreno, Rui
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Oeyen, Sandra
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Öhman, Christina ...
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Bollen Pinto, Be ...
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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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Zaferidis, Tilem ...
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Guidet, Bertrand
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Artigas, Antonio
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Brorsson, Camill ...
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Spångfors, Marti ...
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Bark, Björn
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Jungner, Mårten
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