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Medical resource utilization patterns and mortality rates according to age among critically ill patients admitted to a medical intensive care unit

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Název: Medical resource utilization patterns and mortality rates according to age among critically ill patients admitted to a medical intensive care unit
Přispěvatelé: Oh, Dong Kyu, Na, Wonjun, Park, Yu Rang, Hong, Sang-Bum, Lim, Chae-Man, Koh, Younsuck, Huh, Jin-Won
Informace o vydavateli: Lippincott Williams & Wilkins
Rok vydání: 2019
Témata: Adult, Age Factors, Aged, 80 and over, Comorbidity, Critical Illness/therapy, Female, Health Resources/statistics & numerical data, Hospital Mortality/trends, Hospitals, Teaching/statistics & numerical data, Humans, Intensive Care Units/statistics & numerical data, Male, Middle Aged, Organ Dysfunction Scores, Renal Replacement Therapy/statistics & numerical data, Republic of Korea, Respiration, Artificial/statistics & numerical data, Retrospective Studies
Popis: There is ongoing controversy about how to address the growing demand for intensive care for critically ill elderly patients. We investigated resource utilization patterns and mortality rates according to age among critically ill patients.We retrospectively analyzed the medical records of patients admitted to a medical intensive care unit (ICU) in a tertiary referral teaching hospital between July 2006 and June 2015. Patients were categorized into non-elderly (age <65 years, n = 4140), young-elderly (age 65-74 years, n = 2306), and old-elderly (age ≥75 years, n = 1508) groups.Among 7954 admissions, the mean age was 61.5 years, and 5061 (63.6%) were of male patients. The proportion of comorbidities increased with age (64.6% in the non-elderly vs 81.4% in the young-elderly vs 82.8% in the old-elderly, P < .001 and P for trend <.001), whereas the baseline Sequential Organ Failure Assessment (SOFA) score decreased with age (8.1 in the non-elderly vs 7.2 in the young-elderly vs 7.2 in the old-elderly, P < .001, R = -.092 and P for trend <.001). Utilization rates of mechanical ventilation (48.6% in the non-elderly vs 48.3% in the young-elderly vs 45.5% in the old-elderly, P = .11) and renal replacement therapy (27.5% in the non-elderly vs 25.5% in the young-elderly vs 24.8% in the old-elderly, P = .069) were comparable between the age groups. The 28-day ICU mortality rates were lower in the young-elderly and the old-elderly groups than in the non-elderly group (35.6% in the non-elderly vs 34.2% in the young-elderly, P = .011; and vs 32.6% in the old-elderly, P = .002).A substantial number of critically ill elderly patients used medical resources as non-elderly patients and showed favorable clinical outcomes. Our results support that underlying medical conditions rather than age per se need to be considered for determining intensive care. ; open
Druh dokumentu: article in journal/newspaper
Jazyk: English
Relation: Medicine; J02214; https://ir.ymlib.yonsei.ac.kr/handle/22282913/170967; T201902523; Medicine, Vol.98(22) : e15835, 2019; 64169
DOI: 10.1097/MD.0000000000015835
Dostupnost: https://ir.ymlib.yonsei.ac.kr/handle/22282913/170967
https://doi.org/10.1097/MD.0000000000015835
Rights: CC BY-NC-ND 2.0 KR
Přístupové číslo: edsbas.8D5AF892
Databáze: BASE
Popis
Abstrakt:There is ongoing controversy about how to address the growing demand for intensive care for critically ill elderly patients. We investigated resource utilization patterns and mortality rates according to age among critically ill patients.We retrospectively analyzed the medical records of patients admitted to a medical intensive care unit (ICU) in a tertiary referral teaching hospital between July 2006 and June 2015. Patients were categorized into non-elderly (age <65 years, n = 4140), young-elderly (age 65-74 years, n = 2306), and old-elderly (age ≥75 years, n = 1508) groups.Among 7954 admissions, the mean age was 61.5 years, and 5061 (63.6%) were of male patients. The proportion of comorbidities increased with age (64.6% in the non-elderly vs 81.4% in the young-elderly vs 82.8% in the old-elderly, P < .001 and P for trend <.001), whereas the baseline Sequential Organ Failure Assessment (SOFA) score decreased with age (8.1 in the non-elderly vs 7.2 in the young-elderly vs 7.2 in the old-elderly, P < .001, R = -.092 and P for trend <.001). Utilization rates of mechanical ventilation (48.6% in the non-elderly vs 48.3% in the young-elderly vs 45.5% in the old-elderly, P = .11) and renal replacement therapy (27.5% in the non-elderly vs 25.5% in the young-elderly vs 24.8% in the old-elderly, P = .069) were comparable between the age groups. The 28-day ICU mortality rates were lower in the young-elderly and the old-elderly groups than in the non-elderly group (35.6% in the non-elderly vs 34.2% in the young-elderly, P = .011; and vs 32.6% in the old-elderly, P = .002).A substantial number of critically ill elderly patients used medical resources as non-elderly patients and showed favorable clinical outcomes. Our results support that underlying medical conditions rather than age per se need to be considered for determining intensive care. ; open
DOI:10.1097/MD.0000000000015835