Bora Lee1, Sungwon Na1, Miran Park1, Sungyeon Ham1, Jeongmin Kim2. 1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. 2. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. anesjeongmin@yuhs.ac.
Abstract
BACKGROUND: Owing to an aging society, both the number of operations for patients aged >85 years and the average age of patients admitted to the intensive care unit (ICU) are rapidly increasing. However, mortality is not an appropriate outcome measurement in patients aged >85 years; a more important outcome is home return (HR), because quality of life is valuable to these patients. We identified predictors for HR of patients aged >85 years admitted to the ICU after surgery. METHODS: Retrospective analysis of medical records was conducted at a university hospital. Patients aged > 85 years, admitted to the ICU after surgery from March 2006 to June 2015 (n = 187), were divided into a HR group (patients who returned home after discharge) and non-HR group (deceased or transferred to nursing facilities). Perioperative data and outcome were assessed and compared. Multivariate logistic regression analysis was conducted to identify independent predictors. RESULTS: The average age of patients was 88 years. HR occurred in 61% of patients, and mortality was 9%. The HR group had higher preoperative albumin level than did the non-HR group. More patients in the non-HR group experienced hip surgery than in the HR group (51 vs. 12%, P < 0.001). APACHE II score was higher (P < 0.001) in the non-HR group. In multivariate analysis, preoperative albumin, hip surgery, and APACHE II score were independent predictors of HR. CONCLUSION: Predictors of HR of surgical critically ill elderly patients included preoperative albumin level, hip surgery, and APACHE II score on ICU admission.
BACKGROUND: Owing to an aging society, both the number of operations for patients aged >85 years and the average age of patients admitted to the intensive care unit (ICU) are rapidly increasing. However, mortality is not an appropriate outcome measurement in patients aged >85 years; a more important outcome is home return (HR), because quality of life is valuable to these patients. We identified predictors for HR of patients aged >85 years admitted to the ICU after surgery. METHODS: Retrospective analysis of medical records was conducted at a university hospital. Patients aged > 85 years, admitted to the ICU after surgery from March 2006 to June 2015 (n = 187), were divided into a HR group (patients who returned home after discharge) and non-HR group (deceased or transferred to nursing facilities). Perioperative data and outcome were assessed and compared. Multivariate logistic regression analysis was conducted to identify independent predictors. RESULTS: The average age of patients was 88 years. HR occurred in 61% of patients, and mortality was 9%. The HR group had higher preoperative albumin level than did the non-HR group. More patients in the non-HR group experienced hip surgery than in the HR group (51 vs. 12%, P < 0.001). APACHE II score was higher (P < 0.001) in the non-HR group. In multivariate analysis, preoperative albumin, hip surgery, and APACHE II score were independent predictors of HR. CONCLUSION: Predictors of HR of surgical critically ill elderly patients included preoperative albumin level, hip surgery, and APACHE II score on ICU admission.
Authors: T J Mattimore; N S Wenger; N A Desbiens; J M Teno; M B Hamel; H Liu; R Califf; A F Connors; J Lynn; R K Oye Journal: J Am Geriatr Soc Date: 1997-07 Impact factor: 5.562
Authors: Murtuza Faizi; Adam J Farrier; Murali Venkatesan; Christopher Thomas; Chika Edward Uzoigwe; Siva Balasubramanian; Robert P Smith Journal: Injury Date: 2014-12 Impact factor: 2.586
Authors: Sandra Eminovic; Gabor Vincze; Doris Eglseer; Regina Riedl; Patrick Sadoghi; Andreas Leithner; Gerwin A Bernhardt Journal: Int Orthop Date: 2020-11-26 Impact factor: 3.075
Authors: Diana de Jesus Neves Silva; Luís Guilherme Galego Casimiro; Mónica Isabel Sequeira de Oliveira; Luciana Brás da Cunha Ferreira; Fernando José Pereira Alves Abelha Journal: Braz J Anesthesiol Date: 2020-02-19