Outcomes of very elderly (≥ 80 years) critical-ill patients in a medical intensive care unit of a tertiary hospital in Korea
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background/Aims: This study evaluated clinical characteristics and outcomes in very elderly (≥ 80 years of age) critical-ill patients admitted to a medical intensive care unit (MICU) in a regional single tertiary hospital. Methods: We retrospectively evaluated prospectively collected data in the MICU for the period of December 2011 to May 2014. Patients were divided into ≥ 80 and < 80 years of age and clinical characteristics and outcomes were compared among these patients. Results: A total of 468 patients were evaluated and 102 patients (21.7%) were ≥ 80 years of age. Overall mortality was 38.5% in the intensive care unit (ICU) and 44.7% in the hospital. There was no significant difference in ICU and in-hospital mortalities between those ≥ 80 years and those < 80 years (34.9% vs. 39.5% for ICU mortality; 40.6% vs. 45.9% for in-hospital mortality). Lengths of ICU and hospital stays were significantly longer in patients < 80 years compared to patients ≥ 80 years (10.57 ± 19.96 days vs. 8.19 ± 8.78 days for ICU stay; 27.95 ± 39.62 days vs. 18.17 ± 15.44 days for hospital stay). The rate of withholding intensive care in hospital stay over 48 hours was significantly higher in patients ≥ 80 years compared to patients < 80 years (22.9% vs. 11.8%). In multivariate analysis, weaning failure and withdrawal or withholding of intensive care in ICU was significantly related to death in patients with age ≥ 80. Conclusions: Clinical outcomes were not significantly different for very elderly critical-ill patients compared to those of their younger counterparts in the MICU in this study.
Abstract
Background/Aims: This study evaluated clinical characteristics and outcomes in very elderly (≥ 80 years of age) critical-ill patients admitted to a medical intensive care unit (MICU) in a regional single tertiary hospital. Methods: We retrospectively evaluated prospectively collected data in the MICU for the period of December 2011 to May 2014. Patients were divided into ≥ 80 and < 80 years of age and clinical characteristics and outcomes were compared among these patients. Results: A total of 468 patients were evaluated and 102 patients (21.7%) were ≥ 80 years of age. Overall mortality was 38.5% in the intensive care unit (ICU) and 44.7% in the hospital. There was no significant difference in ICU and in-hospital mortalities between those ≥ 80 years and those < 80 years (34.9% vs. 39.5% for ICU mortality; 40.6% vs. 45.9% for in-hospital mortality). Lengths of ICU and hospital stays were significantly longer in patients < 80 years compared to patients ≥ 80 years (10.57 ± 19.96 days vs. 8.19 ± 8.78 days for ICU stay; 27.95 ± 39.62 days vs. 18.17 ± 15.44 days for hospital stay). The rate of withholding intensive care in hospital stay over 48 hours was significantly higher in patients ≥ 80 years compared to patients < 80 years (22.9% vs. 11.8%). In multivariate analysis, weaning failure and withdrawal or withholding of intensive care in ICU was significantly related to death in patients with age ≥ 80. Conclusions: Clinical outcomes were not significantly different for very elderly critical-ill patients compared to those of their younger counterparts in the MICU in this study.
참고문헌 (16)
- Bagshaw SM, "Very old patients admitted to intensive care in Australia and New Zealand:a multi-centre cohort analysis", Crit Care, 13, pp.R45~ (2009)
- Jakob SM, "Intensive care 1980-1995: change in patient characteristics, nursing workload and outcome", Intensive Care Med, 23, pp.1165~1170 (1997)
- Rellos K, "Outcome of critically ill oldest-old patients (aged 90 and older) admitted to the intensive care unit", J Am Geriatr Soc, 54, pp.110~114 (2006)
- "Population census: complete enumeration results of the 2015 population and housing census" (1996)[URL]
- 정병호, "Clinical Demographics and Outcomes in Mechanically Ventilated Patients in Korean Intensive Care Units", Journal of Korean Medical Science, 29(6), pp.864~870 (2014), 대한의학회
- 곽상현, "Current Status of Intensive Care Units Registered as Critical Care Subspecialty Training Hospitals in Korea", Journal of Korean Medical Science, 29(3), pp.431~437 (2014), 대한의학회
- Sim YS, "Mortality and outcomes in very elderly patients 90 years of age or older admitted to the ICU", Respir Care, 60, pp.347~355 (2015)
- Smith G, "ABC of intensive care: criteria for admission", BMJ, 318, pp.1544~1547 (1999)
- Moreno R, "Outcome prediction in intensive care: results of a prospective, multicentre, Portuguese study", Intensive Care Med, 23, pp.177~186 (1997)
- Fuchs L, "ICU admission characteristics and mortality rates among elderly and very elderly patients", Intensive Care Med, 38, pp.1654~1661 (2012)
- Somme D, "Critically ill old and the oldest-old patients in intensive care: short- and long-term outcomes", Intensive Care Med, 29, pp.2137~2143 (2003)
- Phua J, "Withholding and withdrawal of life-sustaining treatments in intensive care units in Asia", JAMA Intern Med, 175, pp.363~371 (2015)
- Guidet B, "The Durban World Congress Ethics Round Table Conference Report. II. Withholding or withdrawing of treatment in elderly patients admitted to the intensive care unit", J Crit Care, 29, pp.896~901 (2014)
- Epstein SK, "Effect of failed extubation on the outcome of mechanical ventilation", Chest, 112, pp.186~192 (1997)
- Rothaar RC, "Extubation failure: magnitude of the problem, impact on outcomes, and prevention", Curr Opin Crit Care, 9, pp.59~66 (2003)
- Chen CM, "Age is an important predictor of failed unplanned extubation", Int J Gerontol, 4, pp.120~129 (2010)
