Contemporary assessment of short- and functional 90-days outcome in old intensive care patients suffering from COVID-19

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2024-12-03 DOI:10.1016/j.jcrc.2024.154984

Raphael Romano Bruno , Bernhard Wernly , Antonio Artigas , Kristina Fuest , Stefan J. Schaller , Lisa Dannenberg , Detlef Kindgen-Milles , Malte Kelm , Michael Beil , Sigal Sviri , Muhammed Elhadi , Michael Joannidis , Sandra Oeyen , Eumorfia Kondili , Rui Moreno , Susannah Leaver , Bertrand Guidet , Dylan W. De Lange , Hans Flaatten , Wojciech Szczeklik , Christian Jung

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引用次数: 0

Abstract

Purpose

There are limited data about the outcome of old intensive care (ICU) patients suffering from Covid-19 in the post-vaccination era. This study distinguishes the pre- and post-acute illness living conditions of ICU survivors from non-survivors.

Methods

This prospective international multicenter study included 642 old (≥ 70 years) ICU patients, including data ranging from pre-illness condition to functional 90-days follow-up. The primary endpoint was the difference of living conditions of ICU-survivors before ICU admission and 90-days after ICU discharge. Secondary outcomes were 90-days mortality, and quality of life.

Results

A total of 642 patients were included. Significantly more ICU survivors lived at their own homes without support before ICU admission than non-survivors (p = 0.016), while more non-survivors resided in nursing homes (p = 0.016). ICU mortality was 39 %, 30-days and 90 days mortality were 47 %and 55 %. After 90 days, only 22 % maintained the same living conditions. Surviving patients viewed ICU admission positively after 90 days, while relatives were more uncertain. Quality of life indicated a self-reported average score of 60 (50–75).

Conclusion

Living conditions influence the outcome of critically ill old patients suffering from Covid-19. Only a minority returned to their initial habitat after ICU survival.

Trial registration number NCT04321265

Abstract Image

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COVID-19老年重症监护患者90天短期和功能性结局的当代评估

目的：疫苗接种后，老年重症监护（ICU）患者感染Covid-19的预后数据有限。本研究区分了ICU幸存者和非幸存者的急性疾病前和急性疾病后的生活条件。方法：本前瞻性国际多中心研究纳入642例老年（≥70岁）ICU患者，包括从病前状态到功能90天随访的数据。主要终点是ICU患者入院前和出院后90天的生活状况差异。次要结局是90天死亡率和生活质量。结果：共纳入642例患者。ICU幸存者比非幸存者在ICU入院前住在自己家中没有支持的人数显著增加（p = 0.016），而非幸存者住在养老院的人数显著增加（p = 0.016）。ICU病死率为39%，30天和90天病死率分别为47%和55%。90天后，只有22%的人保持了同样的生活条件。存活患者90天后对ICU入院的态度是积极的，而家属则不确定。生活质量表明自我报告的平均得分为60分（50-75分）。结论：生活条件影响老年危重患者的预后。只有少数在ICU存活后回到了最初的栖息地。试验注册号bernct04321265。

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.