Cargando…
Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit
Background. Data on long-term outcomes of elderly (≥65 years) patients in ICU are sparse. Materials and Methods. Adult patients (n = 1563, 45.4% elderly) admitted over 28 months were analyzed by competing risks regression model to determine independent factors related to in-hospital and long-term mo...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi Publishing Corporation
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280808/ https://www.ncbi.nlm.nih.gov/pubmed/25580439 http://dx.doi.org/10.1155/2014/960575 |
_version_ | 1782350904007065600 |
---|---|
author | Mukhopadhyay, A. Tai, B. C. See, K. C. Ng, W. Y. Lim, T. K. Onsiong, S. Ee, S. Chua, M. J. Lee, P. R. Loh, M. L. Phua, J |
author_facet | Mukhopadhyay, A. Tai, B. C. See, K. C. Ng, W. Y. Lim, T. K. Onsiong, S. Ee, S. Chua, M. J. Lee, P. R. Loh, M. L. Phua, J |
author_sort | Mukhopadhyay, A. |
collection | PubMed |
description | Background. Data on long-term outcomes of elderly (≥65 years) patients in ICU are sparse. Materials and Methods. Adult patients (n = 1563, 45.4% elderly) admitted over 28 months were analyzed by competing risks regression model to determine independent factors related to in-hospital and long-term mortality. Results. 414 (26.5%) and 337 (21.6%) patients died in-hospital and during the 52 months following discharge, respectively; the elderly group had higher mortality during both periods. After discharge, elderly patients had 2.3 times higher mortality compared to the general population of the same age-group. In-hospital mortality was independently associated with mechanical ventilation (subdistribution hazard ratio (SHR) 2.74), vasopressors (SHR 2.56), neurological disease (SHR 1.77), and Mortality Prediction Model II score (SHR 1.01) regardless of age and with malignancy (SHR, hematological 3.65, nonhematological 3.4) and prior renal replacement therapy (RRT, SHR 2.21) only in the elderly. Long-term mortality was associated with low hemoglobin concentration (SHR 0.94), airway disease (SHR 2.23), and malignancy (SHR hematological 1.11, nonhematological 2.31) regardless of age and with comorbidities especially among the nonelderly. Conclusions. Following discharge, elderly ICU patients have higher mortality compared to the nonelderly and general population. In the elderly group, prior RRT and malignancy contribute additionally to in-hospital mortality risk. In the long-term, comorbidities (age-related), anemia, airway disease, and malignancy were significantly associated with mortality. |
format | Online Article Text |
id | pubmed-4280808 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Hindawi Publishing Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-42808082015-01-11 Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit Mukhopadhyay, A. Tai, B. C. See, K. C. Ng, W. Y. Lim, T. K. Onsiong, S. Ee, S. Chua, M. J. Lee, P. R. Loh, M. L. Phua, J Biomed Res Int Research Article Background. Data on long-term outcomes of elderly (≥65 years) patients in ICU are sparse. Materials and Methods. Adult patients (n = 1563, 45.4% elderly) admitted over 28 months were analyzed by competing risks regression model to determine independent factors related to in-hospital and long-term mortality. Results. 414 (26.5%) and 337 (21.6%) patients died in-hospital and during the 52 months following discharge, respectively; the elderly group had higher mortality during both periods. After discharge, elderly patients had 2.3 times higher mortality compared to the general population of the same age-group. In-hospital mortality was independently associated with mechanical ventilation (subdistribution hazard ratio (SHR) 2.74), vasopressors (SHR 2.56), neurological disease (SHR 1.77), and Mortality Prediction Model II score (SHR 1.01) regardless of age and with malignancy (SHR, hematological 3.65, nonhematological 3.4) and prior renal replacement therapy (RRT, SHR 2.21) only in the elderly. Long-term mortality was associated with low hemoglobin concentration (SHR 0.94), airway disease (SHR 2.23), and malignancy (SHR hematological 1.11, nonhematological 2.31) regardless of age and with comorbidities especially among the nonelderly. Conclusions. Following discharge, elderly ICU patients have higher mortality compared to the nonelderly and general population. In the elderly group, prior RRT and malignancy contribute additionally to in-hospital mortality risk. In the long-term, comorbidities (age-related), anemia, airway disease, and malignancy were significantly associated with mortality. Hindawi Publishing Corporation 2014 2014-12-16 /pmc/articles/PMC4280808/ /pubmed/25580439 http://dx.doi.org/10.1155/2014/960575 Text en Copyright © 2014 A. Mukhopadhyay et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Mukhopadhyay, A. Tai, B. C. See, K. C. Ng, W. Y. Lim, T. K. Onsiong, S. Ee, S. Chua, M. J. Lee, P. R. Loh, M. L. Phua, J Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit |
title | Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit |
title_full | Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit |
title_fullStr | Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit |
title_full_unstemmed | Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit |
title_short | Risk Factors for Hospital and Long-Term Mortality of Critically Ill Elderly Patients Admitted to an Intensive Care Unit |
title_sort | risk factors for hospital and long-term mortality of critically ill elderly patients admitted to an intensive care unit |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280808/ https://www.ncbi.nlm.nih.gov/pubmed/25580439 http://dx.doi.org/10.1155/2014/960575 |
work_keys_str_mv | AT mukhopadhyaya riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT taibc riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT seekc riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT ngwy riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT limtk riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT onsiongs riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT ees riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT chuamj riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT leepr riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT lohml riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit AT phuaj riskfactorsforhospitalandlongtermmortalityofcriticallyillelderlypatientsadmittedtoanintensivecareunit |