Lenneke E M Haas1, Ariane Boumendil2, Hans Flaatten3, Bertrand Guidet4, Mercedes Ibarz5, Christian Jung6, Rui Moreno7, Alessandro Morandi8, Finn H Andersen9, Tilemachos Zafeiridis10, Sten Walther11, Sandra Oeyen12, Susannah Leaver13, Ximena Watson14, Carole Boulanger15, Wojciech Szczeklik16, Joerg C Schefold17, Maurizio Cecconi18, Brian Marsh19, Michael Joannidis20, Yuriy Nalapko21, Muhammed Elhadi22, Jesper Fjølner23, Antonio Artigas24, Dylan W de Lange25. 1. Department of Intensive Care Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands. 2. Assistance Publique-Hôpital de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale. Paris F-75012, France. 3. Department of Clinical Medicine, University of Bergen, Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway. 4. Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Service de Réanimation, Sorbonne Université, INSERM, F75012 Paris, France. 5. Department of Intensive Care Medicine, Universitary Hospital Sagrat Cor Barcelona, Spain. 6. Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany. 7. Unidade de Cuidados Intensivos Neurocríticos e Trauma. Hospital de São José, Centro Hospitalar, Faculdade de Ciências Médicas de Lisboa (Nova Medical School), Universitário de Lisboa Central, Lisbon, Portugal. 8. Department of Rehabilitation and Aged Care, Hospital Ancelle, Cremona, Italy. Parc Sanitari Pere Virgili and Vall d'Hebrón Institute of Research, Barcelona, Spain. 9. Department of Anaesthesia and Intensive Care, Ålesund Hospital, Ålesund, Norway, Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway. 10. Intensive Care Unit, General Hospital of Larissa, Larissa, Greece. 11. Department of Cardiothoracic and Vascular Surgery, Heart Centre, Linköping University Hospital, Linköping, Sweden. 12. Department of Intensive Care 1K12IC, Ghent University Hospital, Ghent, Belgium. 13. Research Lead Critical Care Directorate St George's University Hospital, NHS Foundation Trust, London, UK. 14. St George's University Hospital, London, UK. 15. Chair NAHP Section ESICM, Intensive Care Unit, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK. 16. Intensive Care and Perioperative Medicine Division, Jagiellonian University Medical College, Kraków, Poland. 17. Department of Intensive Care Medicine, Inselspital, Universitätsspital, University of Bern, Bern, Switzerland. 18. Department of Anesthesia and Intensive Care Medicine, Humanitas Clinical and Research Center - IRCCS, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Rozzano, MI, Italy. 19. Mater Misericordiae University Hospital, Dublin, Ireland. 20. Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria. 21. European Wellness International, ICU, Luhansk, Ukraine. 22. Faculty of Medicine, University of Tripoli, Tripoli, Libya. 23. Department of Intensive Care, Aarhus University Hospital, Aarhus, Denmark. 24. Department of Intensive Care Medicine, CIBER Enfermedades Respiratorias, Corporacion Sanitaria Universitaria Parc Tauli, Autonomous University of Barcelona. Sabadell, Spain. 25. Department of Intensive Care Medicine, University Medical Center, University Utrecht, Utrecht, The Netherlands.
Abstract
BACKGROUND: Sepsis is one of the most frequent reasons for acute intensive care unit (ICU) admission of very old patients and mortality rates are high. However, the impact of pre-existing physical and cognitive function on long-term outcome of ICU patients ≥ 80 years old (very old intensive care patients (VIPs)) with sepsis is unclear. OBJECTIVE: To investigate both the short- and long-term mortality of VIPs admitted with sepsis and assess the relation of mortality with pre-existing physical and cognitive function. DESIGN: Prospective cohort study. SETTING: 241 ICUs from 22 European countries in a six-month period between May 2018 and May 2019. SUBJECTS: Acutely admitted ICU patients aged ≥80 years with sequential organ failure assessment (SOFA) score ≥ 2. METHODS: Sepsis was defined according to the sepsis 3.0 criteria. Patients with sepsis as an admission diagnosis were compared with other acutely admitted patients. In addition to patients' characteristics, disease severity, information about comorbidity and polypharmacy and pre-existing physical and cognitive function were collected. RESULTS: Out of 3,596 acutely admitted VIPs with SOFA score ≥ 2, a group of 532 patients with sepsis were compared to other admissions. Predictors for 6-month mortality were age (per 5 years): Hazard ratio (HR, 1.16 (95% confidence interval (CI), 1.09-1.25, P < 0.0001), SOFA (per one-point): HR, 1.16 (95% CI, 1.14-1.17, P < 0.0001) and frailty (CFS > 4): HR, 1.34 (95% CI, 1.18-1.51, P < 0.0001). CONCLUSIONS: There is substantial long-term mortality in VIPs admitted with sepsis. Frailty, age and disease severity were identified as predictors of long-term mortality in VIPs admitted with sepsis.
BACKGROUND:Sepsis is one of the most frequent reasons for acute intensive care unit (ICU) admission of very old patients and mortality rates are high. However, the impact of pre-existing physical and cognitive function on long-term outcome of ICU patients ≥ 80 years old (very old intensive care patients (VIPs)) with sepsis is unclear. OBJECTIVE: To investigate both the short- and long-term mortality of VIPs admitted with sepsis and assess the relation of mortality with pre-existing physical and cognitive function. DESIGN: Prospective cohort study. SETTING: 241 ICUs from 22 European countries in a six-month period between May 2018 and May 2019. SUBJECTS: Acutely admitted ICU patients aged ≥80 years with sequential organ failure assessment (SOFA) score ≥ 2. METHODS:Sepsis was defined according to the sepsis 3.0 criteria. Patients with sepsis as an admission diagnosis were compared with other acutely admitted patients. In addition to patients' characteristics, disease severity, information about comorbidity and polypharmacy and pre-existing physical and cognitive function were collected. RESULTS: Out of 3,596 acutely admitted VIPs with SOFA score ≥ 2, a group of 532 patients with sepsis were compared to other admissions. Predictors for 6-month mortality were age (per 5 years): Hazard ratio (HR, 1.16 (95% confidence interval (CI), 1.09-1.25, P < 0.0001), SOFA (per one-point): HR, 1.16 (95% CI, 1.14-1.17, P < 0.0001) and frailty (CFS > 4): HR, 1.34 (95% CI, 1.18-1.51, P < 0.0001). CONCLUSIONS: There is substantial long-term mortality in VIPs admitted with sepsis. Frailty, age and disease severity were identified as predictors of long-term mortality in VIPs admitted with sepsis.
Authors: Ilena Müller; Marco Mancinetti; Anja Renner; Pierre-Olivier Bridevaux; Martin H Brutsche; Christian Clarenbach; Christian Garzoni; Alexandra Lenoir; Bruno Naccini; Sebastian Ott; Lise Piquilloud; Maura Prella; Yok-Ai Que; Paola Marina Soccal; Christophe von Garnier; Thomas K Geiser; Manuela Funke-Chambour; Sabina Guler Journal: BMJ Open Respir Res Date: 2022-04
Authors: Johannes Kerschbaumer; Aleksandrs Krigers; Matthias Demetz; Daniel Pinggera; Julia Klingenschmid; Nadine Pichler; Claudius Thomé; Christian F Freyschlag Journal: J Neurooncol Date: 2022-04-13 Impact factor: 4.506
Authors: Julia Klingenschmid; Aleksandrs Krigers; Daniel Pinggera; Johannes Kerschbaumer; Claudius Thomé; Christian F Freyschlag Journal: J Neurooncol Date: 2022-04-25 Impact factor: 4.506
Authors: Georg Wolff; Bernhard Wernly; Hans Flaatten; Jesper Fjølner; Raphael Romano Bruno; Antonio Artigas; Bernardo Bollen Pinto; Joerg C Schefold; Malte Kelm; Stephan Binneboessel; Philipp Baldia; Michael Beil; Sigal Sivri; Peter Vernon van Heerden; Wojciech Szczeklik; Muhammed Elhadi; Michael Joannidis; Sandra Oeyen; Maria Flamm; Tilemachos Zafeiridis; Brian Marsh; Finn H Andersen; Rui Moreno; Ariane Boumendil; Dylan W De Lange; Bertrand Guidet; Susannah Leaver; Christian Jung Journal: Can J Anaesth Date: 2022-08-09 Impact factor: 6.713