Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit

Jose Orsini, Ashvin Butala, Say Salomon, Sean Studer, Shardul Gadhia, Ben Shamian, Ramesh Prajapati, Christa Blaak

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU. Materials and methods: A single-center, prospective, observational study was carried out among geriatric patients, aged 75 years or older, admitted to ICU. Results: A total of 71 patients were admitted to ICU during the study period. Their mean age was 83 years (range 75-98 years), with a mean Acute Physiology and Chronic Health Evaluation-II score of 21.8 (range 8-39) on admission to ICU. A total of 48 patients (68%) required mechanical ventilation, and 39 (55%) received at least one vasoactive drug. The mean ICU length of stay was 4.6 days (range 1-18 days), and it was similar for ICU survivors and non-survivors (4.7 vs 4.5). A total of 14 patients (19.7%) were admitted after cardiac arrest, and eight (57.1%) of them died in ICU. A total of 28 patients (39.4%) died in the hospital, and 18 (25.4%) died in ICU. Conclusion: Advanced age, critical illness, cardiopulmonary resuscitation, and needs for mechanical ventilation and/or vasopressor therapy are independent risk factors associated with adverse outcome in elderly patients admitted to ICU. Alternatives for ICU admission should be considered in geriatric patients with severe critical illnesses.

Original languageEnglish (US)
Pages (from-to)889-894
Number of pages6
JournalGeriatrics and Gerontology International
Volume15
Issue number7
DOIs
StatePublished - Jul 1 2015
Externally publishedYes

Fingerprint

Critical Illness
Intensive Care Units
Geriatrics
geriatrics
Critical Care
Artificial Respiration
APACHE
illness
Quality of Health Care
Cardiopulmonary Resuscitation
Heart Arrest
Population
Observational Studies
Survivors
Length of Stay
physiology
Prospective Studies
Physicians

Keywords

  • Critically ill
  • Elderly patients
  • Geriatric medicine
  • Intensive care unit
  • Quality of life

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Gerontology
  • Health(social science)
  • Medicine(all)

Cite this

Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit. / Orsini, Jose; Butala, Ashvin; Salomon, Say; Studer, Sean; Gadhia, Shardul; Shamian, Ben; Prajapati, Ramesh; Blaak, Christa.

In: Geriatrics and Gerontology International, Vol. 15, No. 7, 01.07.2015, p. 889-894.

Research output: Contribution to journalArticle

Orsini, Jose ; Butala, Ashvin ; Salomon, Say ; Studer, Sean ; Gadhia, Shardul ; Shamian, Ben ; Prajapati, Ramesh ; Blaak, Christa. / Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit. In: Geriatrics and Gerontology International. 2015 ; Vol. 15, No. 7. pp. 889-894.
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abstract = "Introduction: Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU. Materials and methods: A single-center, prospective, observational study was carried out among geriatric patients, aged 75 years or older, admitted to ICU. Results: A total of 71 patients were admitted to ICU during the study period. Their mean age was 83 years (range 75-98 years), with a mean Acute Physiology and Chronic Health Evaluation-II score of 21.8 (range 8-39) on admission to ICU. A total of 48 patients (68{\%}) required mechanical ventilation, and 39 (55{\%}) received at least one vasoactive drug. The mean ICU length of stay was 4.6 days (range 1-18 days), and it was similar for ICU survivors and non-survivors (4.7 vs 4.5). A total of 14 patients (19.7{\%}) were admitted after cardiac arrest, and eight (57.1{\%}) of them died in ICU. A total of 28 patients (39.4{\%}) died in the hospital, and 18 (25.4{\%}) died in ICU. Conclusion: Advanced age, critical illness, cardiopulmonary resuscitation, and needs for mechanical ventilation and/or vasopressor therapy are independent risk factors associated with adverse outcome in elderly patients admitted to ICU. Alternatives for ICU admission should be considered in geriatric patients with severe critical illnesses.",
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AU - Orsini, Jose

AU - Butala, Ashvin

AU - Salomon, Say

AU - Studer, Sean

AU - Gadhia, Shardul

AU - Shamian, Ben

AU - Prajapati, Ramesh

AU - Blaak, Christa

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N2 - Introduction: Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU. Materials and methods: A single-center, prospective, observational study was carried out among geriatric patients, aged 75 years or older, admitted to ICU. Results: A total of 71 patients were admitted to ICU during the study period. Their mean age was 83 years (range 75-98 years), with a mean Acute Physiology and Chronic Health Evaluation-II score of 21.8 (range 8-39) on admission to ICU. A total of 48 patients (68%) required mechanical ventilation, and 39 (55%) received at least one vasoactive drug. The mean ICU length of stay was 4.6 days (range 1-18 days), and it was similar for ICU survivors and non-survivors (4.7 vs 4.5). A total of 14 patients (19.7%) were admitted after cardiac arrest, and eight (57.1%) of them died in ICU. A total of 28 patients (39.4%) died in the hospital, and 18 (25.4%) died in ICU. Conclusion: Advanced age, critical illness, cardiopulmonary resuscitation, and needs for mechanical ventilation and/or vasopressor therapy are independent risk factors associated with adverse outcome in elderly patients admitted to ICU. Alternatives for ICU admission should be considered in geriatric patients with severe critical illnesses.

AB - Introduction: Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU. Materials and methods: A single-center, prospective, observational study was carried out among geriatric patients, aged 75 years or older, admitted to ICU. Results: A total of 71 patients were admitted to ICU during the study period. Their mean age was 83 years (range 75-98 years), with a mean Acute Physiology and Chronic Health Evaluation-II score of 21.8 (range 8-39) on admission to ICU. A total of 48 patients (68%) required mechanical ventilation, and 39 (55%) received at least one vasoactive drug. The mean ICU length of stay was 4.6 days (range 1-18 days), and it was similar for ICU survivors and non-survivors (4.7 vs 4.5). A total of 14 patients (19.7%) were admitted after cardiac arrest, and eight (57.1%) of them died in ICU. A total of 28 patients (39.4%) died in the hospital, and 18 (25.4%) died in ICU. Conclusion: Advanced age, critical illness, cardiopulmonary resuscitation, and needs for mechanical ventilation and/or vasopressor therapy are independent risk factors associated with adverse outcome in elderly patients admitted to ICU. Alternatives for ICU admission should be considered in geriatric patients with severe critical illnesses.

KW - Critically ill

KW - Elderly patients

KW - Geriatric medicine

KW - Intensive care unit

KW - Quality of life

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