Mortality in Elderly Patients With Thermoregulatory Failure

Kramer, Mordechai R.; Vandijk, Jehuda; Rosin, Arnold J.

doi:10.1001/archinte.1989.00390070061006

Cited by 35 publications

(7 citation statements)

References 16 publications

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“…It has been demonstrated that activated T lymphocytes from older individuals show a significant reduction in the induction of nuclear factor‐κβ (NF‐κβ), a ubiquitous transcription factor that increases the expression of genes for the proinflammatory cytokines 17 , 18 19 , 20 , 21 although older patients are less likely to mount a febrile response to trauma and infection 22 , 23 , 24 . Furthermore, we have observed that older patients tend to have a less intense systemic inflammatory response to infection and to be less hyperdynamic when compared with younger patients.…”

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confidence: 99%

The Effect of Aging on Circulating Levels of Proinflammatory Cytokines During Septic Shock

Marik

Zaloga

2001

Journal of the American Geriatrics Society

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confidence: 99%

The Effect of Aging on Circulating Levels of Proinflammatory Cytokines During Septic Shock

Marik

Zaloga

2001

Journal of the American Geriatrics Society

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“…Elderly individuals are at very high risk of developing heat stroke, hyperthermia, and hypothermia compared to younger individuals. Febrile response to infection is decreased in the elderly, and mortality is higher in patients with absent febrile response [36].…”

Section: Pathophysiologic Considerations In the Elderly With Criticalmentioning

confidence: 99%

Critical Illness in the Elderly: Review of Pathophysiology of Aging and Outcome of Intensive Care

Chelluri¹

2001

J Intensive Care Med

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The goal of this article is to review the literature on age and its influence on the pathophysiology of critical illness, outcome after critical illness, and end of life decision making in critically ill elderly patients. Sources for this review included the MEDLINE database and bibliographies of original articles, reviews, and book chapters. The population is aging and the need for medical care and its costs increase with increasing age. A majority of the elderly lead independent lives, although some need help with various functional activities related to daily living. It is difficult to separate the effects of aging from the effects of the comorbidities that develop with increasing age. The physiologic reserve decreases in the elderly and they may not be able to tolerate a critical injury or illness as well as a younger individual. As the elderly are usually on multiple medications, they are prone to have more drug interactions and side effects, and need close monitoring of the drugs and adjustment of the dosage. Mortality after a critical illness in the elderly is higher compared to younger patients, and it is more related to the acuity of physiologic disturbance than age alone. The effect of age alone on long‐term outcome is not well studied, but individuals with poor functional status and/or increased comorbidities have a poor short‐term outcome. Functional status usually deteriorates after critical illness, but the long‐term survivors usually recover functional abilities, and they are satisfied with their quality of life. Decision making at the end of life is difficult because of the paucity of data on long‐term mortality and quality of life, lack of information about patient wishes, and the uncertainty of the prognosis. Because many elderly patients survive critical illness and may return to their previous lifestyle, age alone should not weigh heavily in end of life decisions. As with other age groups, end of life decisions in the elderly should be made after considering long‐term outcomes, patient goals, and the benefits and burdens of life‐sustaining technology.

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“…Severe hypothermia can be found in association with a number of illnesses (Table 1). Sepsis is one of the most common causes of hypothermia in the elderly and carries a very high mortality rate 28 . It has been suggested that the development of hypothermia in elderly patients should be promptly treated as sepsis unless proven otherwise.…”

Section: Hypothermiamentioning

confidence: 99%