Management and outcomes in critically ill nonagenarian versus octogenarian patients
| Autor(a) principal: | |
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| Data de Publicação: | 2021 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | http://hdl.handle.net/10362/127791 |
Resumo: | Funding Information: This study was endorsed by the ESICM. Free support for running the electronic database and was granted from the dep. of Epidemiology, University of Aarhus, Denmark. Financial support for creation of the e-CRF and maintenance of the database was possible from a grant (open project support) by Western Health region in Norway) 2018 who also funded the participating Norwegian ICUs. DRC Ile de France and URC Est helped conducting VIP2 in France. Open Access funding enabled and organized by Projekt DEAL. Publisher Copyright: © 2021, The Author(s). |
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Management and outcomes in critically ill nonagenarian versus octogenarian patientsFrailtyIntensive care medicineNonagenariansOctogenariansOutcomeGeriatrics and GerontologyFunding Information: This study was endorsed by the ESICM. Free support for running the electronic database and was granted from the dep. of Epidemiology, University of Aarhus, Denmark. Financial support for creation of the e-CRF and maintenance of the database was possible from a grant (open project support) by Western Health region in Norway) 2018 who also funded the participating Norwegian ICUs. DRC Ile de France and URC Est helped conducting VIP2 in France. Open Access funding enabled and organized by Projekt DEAL. Publisher Copyright: © 2021, The Author(s).Background: Intensive care unit (ICU) patients age 90 years or older represent a growing subgroup and place a huge financial burden on health care resources despite the benefit being unclear. This leads to ethical problems. The present investigation assessed the differences in outcome between nonagenarian and octogenarian ICU patients. Methods: We included 7900 acutely admitted older critically ill patients from two large, multinational studies. The primary outcome was 30-day-mortality, and the secondary outcome was ICU-mortality. Baseline characteristics consisted of frailty assessed by the Clinical Frailty Scale (CFS), ICU-management, and outcomes were compared between octogenarian (80–89.9 years) and nonagenarian (> 90 years) patients. We used multilevel logistic regression to evaluate differences between octogenarians and nonagenarians. Results: The nonagenarians were 10% of the entire cohort. They experienced a higher percentage of frailty (58% vs 42%; p < 0.001), but lower SOFA scores at admission (6 + 5 vs. 7 + 6; p < 0.001). ICU-management strategies were different. Octogenarians required higher rates of organ support and nonagenarians received higher rates of life-sustaining treatment limitations (40% vs. 33%; p < 0.001). ICU mortality was comparable (27% vs. 27%; p = 0.973) but a higher 30-day-mortality (45% vs. 40%; p = 0.029) was seen in the nonagenarians. After multivariable adjustment nonagenarians had no significantly increased risk for 30-day-mortality (aOR 1.25 (95% CI 0.90–1.74; p = 0.19)). Conclusion: After adjustment for confounders, nonagenarians demonstrated no higher 30-day mortality than octogenarian patients. In this study, being age 90 years or more is no particular risk factor for an adverse outcome. This should be considered– together with illness severity and pre-existing functional capacity - to effectively guide triage decisions. Trial registration: NCT03134807 and NCT03370692.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNBruno, Raphael RomanoWernly, BernhardKelm, MalteBoumendil, ArianeMorandi, AlessandroAndersen, Finn H.Artigas, AntonioFinazzi, StefanoCecconi, MaurizioChristensen, SteffenFaraldi, LoredanaLichtenauer, MichaelMuessig, Johanna M.Marsh, BrianMoreno, RuiOeyen, SandraÖhman, Christina AgvaldPinto, Bernardo BollenSoliman, Ivo W.Szczeklik, WojciechValentin, AndreasWatson, XimenaLeaver, SusannahBoulanger, CaroleWalther, StenSchefold, Joerg C.Joannidis, MichaelNalapko, YuriyElhadi, MuhammedFjølner, JesperZafeiridis, TilemachosDe Lange, Dylan W.Guidet, BertrandFlaatten, HansJung, ChristianJoannidis, MichaelEller, PhilippHelbok, RaimundSchmutz, RenéNollet, Jokede Neve, NikolaasBuysscher, Pieter DeOeyen, SandraSwinnen, WalterMikačić, MarijanaBastiansen, AndersHusted, AndreasDahle, Bård E.S.Cramer, ChristineSølling, Christoffer2021-11-15T23:36:43Z2021-122021-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/127791eng1471-2318PURE: 34677420https://doi.org/10.1186/s12877-021-02476-4info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-05-22T17:57:13Zoai:run.unl.pt:10362/127791Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-05-22T17:57:13Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
Management and outcomes in critically ill nonagenarian versus octogenarian patients |
| title |
Management and outcomes in critically ill nonagenarian versus octogenarian patients |
| spellingShingle |
Management and outcomes in critically ill nonagenarian versus octogenarian patients Bruno, Raphael Romano Frailty Intensive care medicine Nonagenarians Octogenarians Outcome Geriatrics and Gerontology |
| title_short |
Management and outcomes in critically ill nonagenarian versus octogenarian patients |
| title_full |
Management and outcomes in critically ill nonagenarian versus octogenarian patients |
| title_fullStr |
Management and outcomes in critically ill nonagenarian versus octogenarian patients |
| title_full_unstemmed |
Management and outcomes in critically ill nonagenarian versus octogenarian patients |
| title_sort |
Management and outcomes in critically ill nonagenarian versus octogenarian patients |
| author |
Bruno, Raphael Romano |
| author_facet |
Bruno, Raphael Romano Wernly, Bernhard Kelm, Malte Boumendil, Ariane Morandi, Alessandro Andersen, Finn H. Artigas, Antonio Finazzi, Stefano Cecconi, Maurizio Christensen, Steffen Faraldi, Loredana Lichtenauer, Michael Muessig, Johanna M. Marsh, Brian Moreno, Rui Oeyen, Sandra Öhman, Christina Agvald Pinto, Bernardo Bollen Soliman, Ivo W. Szczeklik, Wojciech Valentin, Andreas Watson, Ximena Leaver, Susannah Boulanger, Carole Walther, Sten Schefold, Joerg C. Joannidis, Michael Nalapko, Yuriy Elhadi, Muhammed Fjølner, Jesper Zafeiridis, Tilemachos De Lange, Dylan W. Guidet, Bertrand Flaatten, Hans Jung, Christian Eller, Philipp Helbok, Raimund Schmutz, René Nollet, Joke de Neve, Nikolaas Buysscher, Pieter De Swinnen, Walter Mikačić, Marijana Bastiansen, Anders Husted, Andreas Dahle, Bård E.S. Cramer, Christine Sølling, Christoffer |
| author_role |
author |
| author2 |
Wernly, Bernhard Kelm, Malte Boumendil, Ariane Morandi, Alessandro Andersen, Finn H. Artigas, Antonio Finazzi, Stefano Cecconi, Maurizio Christensen, Steffen Faraldi, Loredana Lichtenauer, Michael Muessig, Johanna M. Marsh, Brian Moreno, Rui Oeyen, Sandra Öhman, Christina Agvald Pinto, Bernardo Bollen Soliman, Ivo W. Szczeklik, Wojciech Valentin, Andreas Watson, Ximena Leaver, Susannah Boulanger, Carole Walther, Sten Schefold, Joerg C. Joannidis, Michael Nalapko, Yuriy Elhadi, Muhammed Fjølner, Jesper Zafeiridis, Tilemachos De Lange, Dylan W. Guidet, Bertrand Flaatten, Hans Jung, Christian Eller, Philipp Helbok, Raimund Schmutz, René Nollet, Joke de Neve, Nikolaas Buysscher, Pieter De Swinnen, Walter Mikačić, Marijana Bastiansen, Anders Husted, Andreas Dahle, Bård E.S. Cramer, Christine Sølling, Christoffer |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
| dc.contributor.author.fl_str_mv |
Bruno, Raphael Romano Wernly, Bernhard Kelm, Malte Boumendil, Ariane Morandi, Alessandro Andersen, Finn H. Artigas, Antonio Finazzi, Stefano Cecconi, Maurizio Christensen, Steffen Faraldi, Loredana Lichtenauer, Michael Muessig, Johanna M. Marsh, Brian Moreno, Rui Oeyen, Sandra Öhman, Christina Agvald Pinto, Bernardo Bollen Soliman, Ivo W. Szczeklik, Wojciech Valentin, Andreas Watson, Ximena Leaver, Susannah Boulanger, Carole Walther, Sten Schefold, Joerg C. Joannidis, Michael Nalapko, Yuriy Elhadi, Muhammed Fjølner, Jesper Zafeiridis, Tilemachos De Lange, Dylan W. Guidet, Bertrand Flaatten, Hans Jung, Christian Joannidis, Michael Eller, Philipp Helbok, Raimund Schmutz, René Nollet, Joke de Neve, Nikolaas Buysscher, Pieter De Oeyen, Sandra Swinnen, Walter Mikačić, Marijana Bastiansen, Anders Husted, Andreas Dahle, Bård E.S. Cramer, Christine Sølling, Christoffer |
| dc.subject.por.fl_str_mv |
Frailty Intensive care medicine Nonagenarians Octogenarians Outcome Geriatrics and Gerontology |
| topic |
Frailty Intensive care medicine Nonagenarians Octogenarians Outcome Geriatrics and Gerontology |
| description |
Funding Information: This study was endorsed by the ESICM. Free support for running the electronic database and was granted from the dep. of Epidemiology, University of Aarhus, Denmark. Financial support for creation of the e-CRF and maintenance of the database was possible from a grant (open project support) by Western Health region in Norway) 2018 who also funded the participating Norwegian ICUs. DRC Ile de France and URC Est helped conducting VIP2 in France. Open Access funding enabled and organized by Projekt DEAL. Publisher Copyright: © 2021, The Author(s). |
| publishDate |
2021 |
| dc.date.none.fl_str_mv |
2021-11-15T23:36:43Z 2021-12 2021-12-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10362/127791 |
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eng |
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eng |
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1471-2318 PURE: 34677420 https://doi.org/10.1186/s12877-021-02476-4 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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