Characteristics and outcomes of nonagenarians admitted to the intensive care unit: A single-centre observational study.

IF 1.2 4区 医学 Q3 ANESTHESIOLOGY
Ariane Flinkier, Laurence Weinberg, Benjamin Churilov, Nattaya Raykateeraroj, Thomas Freeman, Je Min Suh, Angelica Armellini, Ella Francis, Atthaphong Phongphithakchai, Glenn Eastwood, Rinaldo Bellomo, David Pilcher, Dong-Kyu Lee
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Abstract

There is limited data regarding the mortality risk factors for Australian nonagenarians requiring intensive care unit admission. The objectives of the study were to determine the mortality rates, length of stay, and indicators of poor outcomes in nonagenarian patients admitted to the intensive care unit. Data were retrospectively collected from a single-centre university hospital in Australia over a 10-year period. Cox regression survival analysis, hazard ratios (HRs) and receiver operating characteristic curves were used to assess characteristics and associated survival. A total of 25,766 adult patients were admitted to the intensive care unit during the study period, of whom 89 (0.35%) were nonagenarians. The intensive care unit and hospital mortality rates of nonagenarians were 10.1% and 22.5%, respectively. The Australian and New Zealand risk of death model was the most significant predictor of mortality among the risk scoring systems. Nonagenarians who experienced a cardiac arrest had the highest hazard of death in the intensive care unit (HR 7.60, 95% confidence interval (CI) 1.49 to 38.66, P = 0.015) and throughout their hospital admission (HR 6.77, 95% CI 1.52 to 30.28, P = 0.012). Acute renal failure and invasive ventilation had a significantly increased hazard of death in the intensive care unit and hospital admission. Lactate levels also demonstrated a significant increase in the hazard of death per 1 mmol/l increase (HR 1.64, 95% CI 1.3 to 2.08, P < 0.001). Over the study follow-up period of a minimum of 3.5 years, 50 of 89 patients (56.2%) died. Intensive care unit and hospital mortality among nonagenarians admitted to the intensive care unit was relatively low. These findings support early identification of mortality risk factors, allowing for the timely implementation or withdrawal of interventions.

入住重症监护室的90多岁老人的特征和结果:一项单中心观察性研究。
关于澳大利亚需要重症监护病房住院的90多岁老人的死亡风险因素的数据有限。该研究的目的是确定进入重症监护病房的90多岁患者的死亡率、住院时间和不良预后指标。回顾性地收集了澳大利亚一家单中心大学医院10年间的数据。采用Cox回归生存分析、风险比(hr)和受试者工作特征曲线评估特征和相关生存率。在研究期间,共有25,766名成年患者入住重症监护病房,其中89名(0.35%)为老年患者。重症监护病房死亡率和住院死亡率分别为10.1%和22.5%。澳大利亚和新西兰的死亡风险模型是风险评分系统中最重要的死亡率预测因子。经历过心脏骤停的老年患者在重症监护病房(HR 7.60, 95%可信区间(CI) 1.49至38.66,P = 0.015)和整个住院期间的死亡风险最高(HR 6.77, 95% CI 1.52至30.28,P = 0.012)。急性肾衰竭和有创通气在重症监护室和住院期间的死亡风险显著增加。乳酸水平每增加1 mmol/l,死亡风险也显著增加(HR 1.64, 95% CI 1.3 ~ 2.08, P
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来源期刊
CiteScore
2.70
自引率
13.30%
发文量
150
审稿时长
3 months
期刊介绍: Anaesthesia and Intensive Care is an international journal publishing timely, peer reviewed articles that have educational value and scientific merit for clinicians and researchers associated with anaesthesia, intensive care medicine, and pain medicine.
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