Clinical Features and Outcomes of Very Elderly Patients Admitted to the Intensive Care Unit: A Retrospective and Observational Study

Miniksar, Ökkeş Hakan; Özdemi̇r, Mi̇kai̇l

doi:10.5005/jp-journals-10071-23846

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…The requirement of vasopressors in elderly ICU patients is significantly associated with poor outcomes in this study, which is in agreement with earlier reports. 2 , 6 , 24 , 26 – 28 The mortality rate for intubated patients was 28.7%, whereas previous published reports reported mortality rates ranging from 20.3 to 51%. 25 Previous research has shown that the intubation and receipt of mechanical ventilation were associated with increased mortality in elderly ICU patients.…”

Section: Discussionmentioning

confidence: 98%

A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center

Prabhudev¹,

Ramamoorthi²,

Acharya³

2023

Indian Journal of Critical Care Medicine

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A bstract Background The elderly population in India is expected to increase to 319 million by 2050. Managing critically ill elderly patients in intensive care units (ICUs) is a difficult task. Proper planning and development of healthcare infrastructure are of prime importance to face this challenge. Objectives To study the clinical profile and outcomes of elderly patients admitted to the medical ICUs. Materials and methods A time-bound, prospective observational study on elderly patients admitted to medical ICUs for more than 48 hours was conducted from March 2019 to September 2020. The demographic, biochemical, hematologic, and microbiological data on antibiotic susceptibility patterns on various organisms and procalcitonin (PCT) reports were collected. Acute Physiology and Chronic Health Evaluation II (APACHE II) score was calculated. Various treatment modalities, such as mechanical ventilation, inotropes, hemodialysis, antibiotics, culture report in sepsis patients, and length of ICU stay were collected. Results The age of the patients and the length of their ICU stay were not significantly associated with outcomes. Sepsis and APACHE II scores are significantly associated with outcomes. Receipt of mechanical ventilation, vasopressor support, and hemodialysis are significantly associated with mortality ( p < 0.001). Conclusion The patients’ ages were not significantly associated with outcomes. The most common cause of death among elderly patients was found to be sepsis, followed by pneumonia. In elderly ICU patients, gram-negative organisms are the most common causative agents in bloodstream infections. The APACHE II score, sepsis, receipt of mechanical ventilation, vasopressor support, and hemodialysis are significantly associated with mortality. How to cite this article Prabhudev P, Ramamoorthi K, Acharya RV. A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center. Indian J Crit Care Med 2023;27(3):166–175.

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Section: Discussionmentioning

confidence: 98%

A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center

Prabhudev¹,

Ramamoorthi²,

Acharya³

2023

Indian Journal of Critical Care Medicine

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“…Anatomical and physiological changes due to aging pose a challenge for the anesthetic management of elderly patients. A decrease in physical capacity and an increase in the number of accompanying comorbidities are observed in elderly patients (1,4). Frailty is a state of vulnerability to stress factors due to a decrease in both physiological reserves and physical functions dependent on age.…”

Section: Sample Collection and Measurement Of Serum Levels Of Vitamin...mentioning

confidence: 99%

“…Frailty is present in approximately 10% of people over the age of 65 and 25-50% of people over the age of 85 (3,5). Frailty is likely to be common in geriatric patients undergoing surgery and has been strongly associated with increased perioperative morbidity and mortality in these patients (2)(3)(4)(5)(6)(7). The frailty index (FI) is a valuable criterion in the preoperative evaluation of patients undergoing geriatric surgery.…”

Section: Sample Collection and Measurement Of Serum Levels Of Vitamin...mentioning

confidence: 99%

“…Age is an important risk factor for frailty. Due to the increasing elderly population, frailty is frequently encountered in geriatric surgery patients (3)(4)(5)(6)(7).…”

Section: Analysis Of Clinical Variables In Terms Of Frailty Statusmentioning

confidence: 99%

“…All statistically significant values are reported in bold 1. Yates's correction for continuity; 2 Pearson's chi-square test;3 Fisher exact test;4 Kruskal Wallis test;5 One-way analysis of variance. x for age: According to pre-frail group (p=0.03), according to non-frail group (p=0.04).…”

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confidence: 99%

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Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study

Miniksar¹,

Honça²,

Cikrikci³

et al. 2023

JARSS

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Objective: In this study, we aimed to investigate the relationship between vitamin D, frailty and postoperative outcomes in geriatric patients undergoing elective surgery. Methods: In this prospective observational study, a total of 90 elderly patients who had undergone non-cardiac surgery were included. The patients were classified according to the frailty index (FI) score as “Non-frail (FI 0), Pre-frail (FI 1–2) and Frail (FI ≥3)”. In addition, patients were divided into two groups according to serum vitamin D concentration: vitamin D insufficiency group (n=41) and vitamin D sufficiency group (n=49). Clinical characteristics and postoperative outcomes of the patients were compared between the groups. Results: The mean age of the patients was 75.7 ± 7.6 years, the admission rate to Intensive Care Unit (ICU) was 43.3%, and the 30-day mortality rate after surgery was 21.1%. The ICU admission was significantly higher in the “vitamin D insufficiency” group (n=24 versus n=15, p=0.014). In addition, fragility status patients were significantly higher in the “vitamin D insufficiency” group (n=19 versus n=7, p=0.004). Most of the non-frail patients were in the “vitamin D sufficiency” group (n=18 versus n=9). Conclusion: In our study, we observed higher frailty in vitamin D insufficiency patients. In addition, admission to the postoperative ICU was higher in vitamin D insufficiency and frail patients. Our findings show that frailty and vitamin D insufficiency play an important role in postoperative outcomes. Keywords: Vitamin D, frailty, geriatrics, intensive care unit

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Identification and Best Practice Management of Comorbid Geri-Psych Conditions in Critical Care

Koller-Ditto

2023

Critical Care Nursing Clinics of North America

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Clinical Features and Outcomes of Very Elderly Patients Admitted to the Intensive Care Unit: A Retrospective and Observational Study

Cited by 6 publications

References 21 publications

A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center

A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center

Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study

Identification and Best Practice Management of Comorbid Geri-Psych Conditions in Critical Care

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