Ramón Puchades1, Begoña González2, Mar Contreras3, Alejandra Gullón4, Rosa de Miguel5, Daniel Martín6, Carlos Gutiérrez7, Ricardo Navarro8. 1. Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: rpuchades@gmail.com. 2. Intensive Care Unit, La Princesa University Hospital, Madrid, Spain. Electronic address: gmbego@gmail.com. 3. Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: sagu_4@hotmail.coma. 4. Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: alexah_go@hotmail.com. 5. Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: asor33@hotmail.com. 6. Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: daniprote@gmail.coma. 7. Preventive Medicine Service, Gómez-Ulla University Hospital, Madrid, Spain. Electronic address: kargut13@gmail.com. 8. Anesthesiology and Resuscitation Service, Gómez-Ulla University Hospital, Madrid, Spain. Electronic address: r_navarro_suay@yahoo.es.
Abstract
PURPOSE: Data are demonstrating the increase in utilization of critical care by the elderly. Around 11% of ICU patients are ≥80years-old. METHODS: An observational retrospective study was conducted between 2003 and 2011, including elderly patients (≥80years old) admitted from medical services to the intensive care unit (ICU) in a tertiary university hospital. The final sample size was N=202. RESULTS: Mortality rates were: ICU 34.1%, in-hospital 44% and 1-year cumulative mortality 55.4% (20.4% for hospital survivors). Multivariate analysis showed that APACHE II score: OR 1.10, 95% CI (1.03-1.18), SAPS II score: OR 1.03, 95% CI (1.01-1.06), a score <3 on the Cruz Roja Hospital mental scale: 0.51 OR, 95% CI (0.01-0.57) and ICU admission for cardiovascular disease: OR 5.05, 95% CI (1.98-12.84) were independently associated with mortality ICU. Factors independently associated with 1-year mortality were: dyslipidemia OR 7.25 (1.47-35.60), chronic kidney failure OR 13.23, 95% CI (2.28-76.6), stroke OR 10.44, 95% CI (2.26-48.25) and antihypertensive treatment OR 0.08, 95% CI (0.01-0.48). In multiple linear regression, ICU length of stay was associated with mechanical ventilation B coefficient 6.41, 95% CI (1.18-11.64) and in-hospital length of stay was related to age: B coefficient -2.17, 95% CI (-4.02 to -0.33). CONCLUSIONS: Prevalence of cardiovascular risk factors and cardiovascular disease was high, and basal cardiovascular treatment was underused. Primary diagnosis for cardiovascular disease at ICU admission should be assessed as predictor of ICU mortality. Intensifying cardiovascular basal treatment could decrease 1-year mortality. Cardiovascular profile did not show an effect on in-hospital mortality and length of stay.
PURPOSE: Data are demonstrating the increase in utilization of critical care by the elderly. Around 11% of ICU patients are ≥80years-old. METHODS: An observational retrospective study was conducted between 2003 and 2011, including elderly patients (≥80years old) admitted from medical services to the intensive care unit (ICU) in a tertiary university hospital. The final sample size was N=202. RESULTS: Mortality rates were: ICU 34.1%, in-hospital 44% and 1-year cumulative mortality 55.4% (20.4% for hospital survivors). Multivariate analysis showed that APACHE II score: OR 1.10, 95% CI (1.03-1.18), SAPS II score: OR 1.03, 95% CI (1.01-1.06), a score <3 on the Cruz Roja Hospital mental scale: 0.51 OR, 95% CI (0.01-0.57) and ICU admission for cardiovascular disease: OR 5.05, 95% CI (1.98-12.84) were independently associated with mortality ICU. Factors independently associated with 1-year mortality were: dyslipidemia OR 7.25 (1.47-35.60), chronic kidney failure OR 13.23, 95% CI (2.28-76.6), stroke OR 10.44, 95% CI (2.26-48.25) and antihypertensive treatment OR 0.08, 95% CI (0.01-0.48). In multiple linear regression, ICU length of stay was associated with mechanical ventilation B coefficient 6.41, 95% CI (1.18-11.64) and in-hospital length of stay was related to age: B coefficient -2.17, 95% CI (-4.02 to -0.33). CONCLUSIONS: Prevalence of cardiovascular risk factors and cardiovascular disease was high, and basal cardiovascular treatment was underused. Primary diagnosis for cardiovascular disease at ICU admission should be assessed as predictor of ICU mortality. Intensifying cardiovascular basal treatment could decrease 1-year mortality. Cardiovascular profile did not show an effect on in-hospital mortality and length of stay.
Authors: Lenneke E M Haas; Attila Karakus; Rebecca Holman; Sezgin Cihangir; Auke C Reidinga; Nicolette F de Keizer Journal: Crit Care Date: 2015-09-30 Impact factor: 9.097
Authors: Sophie Becker; Jakob Müller; Geraldine de Heer; Stephan Braune; Valentin Fuhrmann; Stefan Kluge Journal: Ann Intensive Care Date: 2015-12-21 Impact factor: 6.925