The impact of age on mortality in the intensive care unit: a retrospective cohort study in Malaysia
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Age is a significant consideration for intensive care unit (ICU) admission. However, the reported associations between increasing age and mortality vary across studies, and data in the local context of Malaysia are lacking. The objective of the present study was to determine the impact of increasing age on ICU mortality. Methods: A retrospective cohort study of ICU patients was conducted between January 2020 and November 2023 at a university hospital in Malaysia. Patients were classified into two categories according to age (years) and into four groups according to National Library of Medicine Medical Subject Headings (MeSH): young adult (19–24), adult (25–44), middle age (45–64) and elderly (≥65). The Cochran-Armitage test for trend and Cox proportional hazards regression analyses were performed to evaluate the impact of increasing age on ICU mortality.Results: A total of 1,661 patients was analyzed. The Cochran-Armitage test showed a significant positive association between ICU mortality rate and age group (Z= −4.86, P<0.01) or MeSH category (Z=−5.36, P<0.01). After adjusting for other confounders, the strongest predictor for ICU mortality in the Cox proportional hazards regression analyses was age, with the elderly age group having the highest adjusted hazard ratio of 4.777 (95% confidence interval, 1.128–20.231; P=0.03).Conclusions: Age had a significant impact on ICU mortality in our cohort of critically ill patients.
Abstract
Background: Age is a significant consideration for intensive care unit (ICU) admission. However, the reported associations between increasing age and mortality vary across studies, and data in the local context of Malaysia are lacking. The objective of the present study was to determine the impact of increasing age on ICU mortality. Methods: A retrospective cohort study of ICU patients was conducted between January 2020 and November 2023 at a university hospital in Malaysia. Patients were classified into two categories according to age (years) and into four groups according to National Library of Medicine Medical Subject Headings (MeSH): young adult (19–24), adult (25–44), middle age (45–64) and elderly (≥65). The Cochran-Armitage test for trend and Cox proportional hazards regression analyses were performed to evaluate the impact of increasing age on ICU mortality.Results: A total of 1,661 patients was analyzed. The Cochran-Armitage test showed a significant positive association between ICU mortality rate and age group (Z= −4.86, P<0.01) or MeSH category (Z=−5.36, P<0.01). After adjusting for other confounders, the strongest predictor for ICU mortality in the Cox proportional hazards regression analyses was age, with the elderly age group having the highest adjusted hazard ratio of 4.777 (95% confidence interval, 1.128–20.231; P=0.03).Conclusions: Age had a significant impact on ICU mortality in our cohort of critically ill patients.
참고문헌 (11)
- Aung YN, "Characteristics and outcome of high-cost ICU patients", Clinicoecon Outcomes Res, 11, pp.505~513 (2019)
- Roller-Wirnsberger R, "The clinical and therapeutic challenge of treating older patients in clinical practice", Br J Clin Pharmacol, 86, pp.1904~1911 (2020)
- Geen O, "Optimizing care for critically ill older adults", CMAJ, 193, pp.E1525~E1533 (2021)
- Lim JU, "Demographic changes in intensive care units in korea over the last decade and outcomes of elderly patients : a single-center retrospective study", Korean J Crit Care Med, 32, pp.164~173 (2017)
- Gonçalves-Pereira J, "Critically ill patient mortality by age : long-term follow-up(CIMbA-LT)", Ann Intensive Care, 13, pp.7~ (2023)
- Rockwood K, "One-year outcome of elderly and young patients admitted to intensive care units", Crit Care Med, 21, pp.687~691 (1993)
- D'Andrea A, "functional independence measure score is associated with mortality in critically ill elderly patients admitted to an intermediate care unit", BMC Geriatr, 20, pp.334~ (2020)
- Cheng X, "Population ageing and mortality during 1990-2017 : a global decomposition analysis", PLoS Med, 17, pp.e1003138~ (2020)
- Malaysia, International Law Book Services, Legal Research Board, "Age of Majority Act 1971 (Act 21): & Guardianship of Infants Act 1961 (Act 351): as at 15th March 2004", International Law Book Services, ~ (2004)
- Heo J, "Changes in the characteristics and long-term mortality rates of intensive care unit patients from 2003 to 2010 : a nationwide population-based cohort study performed in the Republic of Korea", Acute Crit Care, 33, pp.135~145 (2018)
- Vallet H, "Mortality of older patients admitted to an ICU : a systematic review", Crit Care Med, 49, pp.324~334 (2021)
