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Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit.
Geriatr Gerontol Int. 2015 Jul; 15(7):889-94.GG

Abstract

INTRODUCTION

Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU.

MATERIALS AND METHODS

A single-center, prospective, observational study was carried out among geriatric patients, aged 75 years or older, admitted to ICU.

RESULTS

A total of 71 patients were admitted to ICU during the study period. Their mean age was 83 years (range 75-98 years), with a mean Acute Physiology and Chronic Health Evaluation-II score of 21.8 (range 8-39) on admission to ICU. A total of 48 patients (68%) required mechanical ventilation, and 39 (55%) received at least one vasoactive drug. The mean ICU length of stay was 4.6 days (range 1-18 days), and it was similar for ICU survivors and non-survivors (4.7 vs 4.5). A total of 14 patients (19.7%) were admitted after cardiac arrest, and eight (57.1%) of them died in ICU. A total of 28 patients (39.4%) died in the hospital, and 18 (25.4%) died in ICU.

CONCLUSION

Advanced age, critical illness, cardiopulmonary resuscitation, and needs for mechanical ventilation and/or vasopressor therapy are independent risk factors associated with adverse outcome in elderly patients admitted to ICU. Alternatives for ICU admission should be considered in geriatric patients with severe critical illnesses.

Authors+Show Affiliations

Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25255733

Citation

Orsini, Jose, et al. "Prognostic Factors Associated With Adverse Outcome Among Critically Ill Elderly Patients Admitted to the Intensive Care Unit." Geriatrics & Gerontology International, vol. 15, no. 7, 2015, pp. 889-94.
Orsini J, Butala A, Salomon S, et al. Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit. Geriatr Gerontol Int. 2015;15(7):889-94.
Orsini, J., Butala, A., Salomon, S., Studer, S., Gadhia, S., Shamian, B., Prajapati, R., & Blaak, C. (2015). Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit. Geriatrics & Gerontology International, 15(7), 889-94. https://doi.org/10.1111/ggi.12363
Orsini J, et al. Prognostic Factors Associated With Adverse Outcome Among Critically Ill Elderly Patients Admitted to the Intensive Care Unit. Geriatr Gerontol Int. 2015;15(7):889-94. PubMed PMID: 25255733.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit. AU - Orsini,Jose, AU - Butala,Ashvin, AU - Salomon,Say, AU - Studer,Sean, AU - Gadhia,Shardul, AU - Shamian,Ben, AU - Prajapati,Ramesh, AU - Blaak,Christa, Y1 - 2014/09/26/ PY - 2014/07/01/accepted PY - 2014/9/27/entrez PY - 2014/9/27/pubmed PY - 2016/4/1/medline KW - critically ill KW - elderly patients KW - geriatric medicine KW - intensive care unit KW - quality of life SP - 889 EP - 94 JF - Geriatrics & gerontology international JO - Geriatr Gerontol Int VL - 15 IS - 7 N2 - INTRODUCTION: Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU. MATERIALS AND METHODS: A single-center, prospective, observational study was carried out among geriatric patients, aged 75 years or older, admitted to ICU. RESULTS: A total of 71 patients were admitted to ICU during the study period. Their mean age was 83 years (range 75-98 years), with a mean Acute Physiology and Chronic Health Evaluation-II score of 21.8 (range 8-39) on admission to ICU. A total of 48 patients (68%) required mechanical ventilation, and 39 (55%) received at least one vasoactive drug. The mean ICU length of stay was 4.6 days (range 1-18 days), and it was similar for ICU survivors and non-survivors (4.7 vs 4.5). A total of 14 patients (19.7%) were admitted after cardiac arrest, and eight (57.1%) of them died in ICU. A total of 28 patients (39.4%) died in the hospital, and 18 (25.4%) died in ICU. CONCLUSION: Advanced age, critical illness, cardiopulmonary resuscitation, and needs for mechanical ventilation and/or vasopressor therapy are independent risk factors associated with adverse outcome in elderly patients admitted to ICU. Alternatives for ICU admission should be considered in geriatric patients with severe critical illnesses. SN - 1447-0594 UR - https://www.unboundmedicine.com/medline/citation/25255733/Prognostic_factors_associated_with_adverse_outcome_among_critically_ill_elderly_patients_admitted_to_the_intensive_care_unit_ DB - PRIME DP - Unbound Medicine ER -