Prognosis of elderly patients subjected to mechanical ventilation in the ICU

Añón, J.M.; Gómez-Tello, V.; González-Higueras, Elena; Córcoles, V.; Quintana, M.; Lorenzo, A. García de; Oñoro, J.; Martín-Delgado, C.; García-Fernández, Amaya; Marina, Luis María; Gordo, Federico; Choperena, G.; Díaz-Alersi, R.; Montejo, Juan Carlos; López‐Martínez, Jorge Omar

doi:10.1016/j.medine.2012.03.007

Cited by 11 publications

(12 citation statements)

References 29 publications

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“…As reported by others, acute respiratory failure was the most frequent indication for MV (27,28,30,37), accounting for 87.5% of the principal reason for MV for our total study group. There were statistically significant differences in the principal reason for MV among the three age groups (P<0.001).…”

Section: Univariate and Multivariate Logistic Regression Analysessupporting

confidence: 76%

“…However, in the age group of 80 years and older, nearly one-ninth (8.9%) of survivors were transferred to a respiratory care ward. (27)(28)(29)(30). In our study, we found that this proportion of elderly patients was up to 61.5%, and the proportion of very elderly patients was up to 26.0%, which was significantly higher than in the previous studies.…”

Section: Clinical Courses and Outcomescontrasting

confidence: 66%

“…This demographic trend is bound to increase the demand for health care resources. Secondly, there is still a lack of well-defined thresholds for elderly patients, and the definition of the term "elderly" has varied from 65 to 75 years old (7,10,22,23,27,(29)(30)(31)(32)(33)(34)(35)(36). Therefore, the research results may differ.…”

Section: Clinical Courses and Outcomesmentioning

confidence: 99%

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Clinical characteristics and outcomes of mechanically ventilated elderly patients in intensive care units: a Chinese multicentre retrospective study

Ma¹,

Zhu

Jiang

et al. 2021

J Thorac Dis

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Background: In recent years, the number of elderly patients receiving mechanical ventilation (MV) in intensive care units (ICUs) has increased. However, the evidence on the outcomes of elderly mechanically ventilated patients is scant in China. Our objective was to evaluate the characteristics and outcomes in elderly patients (≥65 years) receiving MV in the ICU.Methods: We performed a multicentre retrospective study involving adult patients who were admitted to the ICU and received at least 24 hours of MV. Patients were divided into three age groups: under 65, 65-79, and ≥80 years. The primary outcome was hospital mortality. We performed univariate and multivariate logistic regression analysis to identify factors associated with hospital mortality.Results: A total of 853 patients were analysed. Of those, 61.5% were ≥65 years of age, and 26.0% were ≥80 years of age. There were significant differences in the principal reason for MV among the three age groups (P<0.001). Advanced age was significantly associated with total duration of MV, ICU length of stay (LOS), and ICU costs (all P<0.001), but not with hospital LOS and hospital costs (P>0.05). In addition, mortality rates in the ICU, hospital, and at 60 days significantly increased with age (all P<0.001). In the age group of 80 years and older, the mortality rates were 47.7%, 49.5%, and 50.0%, respectively. Multivariate logistic regression analysis had found that age, Acute Physiology and Chronic Health Evaluation (APACHE) II score, partial pressure of oxygen in arterial blood/fraction of inspired oxygen (PaO 2 /FiO 2 ) ratio, total duration of MV, ICU LOS, and the decision to withhold/withdraw life-sustaining treatments were independent influence factors for mortality rates.Conclusions: Mechanically ventilated elderly patients (≥65 years) have a higher ICU and hospital mortality, but the hospital LOS and hospital costs are similar to younger patients. Advanced age should be considered as a significant independent risk factor for hospital mortality of mechanically ventilated ICU patients.

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Section: Univariate and Multivariate Logistic Regression Analysessupporting

confidence: 76%

Section: Clinical Courses and Outcomescontrasting

confidence: 66%

Section: Clinical Courses and Outcomesmentioning

confidence: 99%

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Clinical characteristics and outcomes of mechanically ventilated elderly patients in intensive care units: a Chinese multicentre retrospective study

Ma¹,

Zhu

Jiang

et al. 2021

J Thorac Dis

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“…The likelihood that exposure to aggressive ICU-level medical will directly lead to death varies widely among patients, depending on age (the elderly are more vulnerable) and underlying medical comorbidities [76, 77]. Although clinicians routinely make subjective assessments regarding patients' chances of tolerating aggressive care, no generally applicable objective risk assessment tool exists for this setting.…”

Section: Review Of the Data And Choice Of Model Parametersmentioning

confidence: 99%

Calculating the Risk Benefit Equation for Aggressive Treatment of Non-convulsive Status Epilepticus

et al. 2012

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Objective To address the question: does non-convulsive status epilepticus warrant the same aggressive treatment as convulsive status epilepticus? Method We used a decision model to evaluate the risks and benefits of treating non-convulsive status epilepticus with intravenous anesthetics and ICU-level aggressive care. We investigated how the decision to use aggressive versus non-aggressive management for non-convulsive status epilepticus impacts expected patient outcome for four etiologies: absence epilepsy, discontinued antiepileptic drugs, intraparenchymal hemorrhage, and hypoxic ischemic encephalopathy. Each etiology was defined by distinct values for five key parameters: baseline mortality rate of the inciting etiology; efficacy of non-aggressive treatment in gaining control of seizures; the relative contribution of seizures to overall mortality; the degree of excess disability expected in the case of delayed seizure control; and the mortality risk of aggressive treatment. Results Non-aggressive treatment was favored for etiologies with low morbidity and mortality such as absence epilepsy and discontinued antiepileptic drugs. The risk of aggressive treatment was only warranted in etiologies where there was significant risk of seizure-induced neurologic damage. In the case of post-anoxic status epilepticus, expected outcomes were poor regardless of the treatment chosen. The favored strategy in each case was determined by strong interactions of all five model parameters. Conclusions Determination of the optimal management approach to non-convulsive status epilepticus is complex and is ultimately determined by the inciting etiology.

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“…The mechanical ventilation not only serve as one of the important means for anesthetization and emergency treatment but also a common treatment means for respiratory support for critically ill patients. The application range of the mechanical ventilation has been expanding in the medical field [1][2]. A large scale survey on conditions of ICU patients by Mealer et al indicates that 39% of the ICU patients received mechanical ventilation in treatment [3].…”

Section: Introductionmentioning

confidence: 99%

Research on Intensive Care Experiences of Patients in Mechanical Ventilation

Hu¹,

Ye²,

Ji³

2019

AJBIO

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To quantitatively analyse conditions of intensive care experiences and influencing factors of patients. A database was established, it can be seen from the overall experience index that in the SD dimensionality, 46.11% patients have highly bad experiences and 86.11% patients have moderate and highly bad experiences in total plus the patients with moderate scores; in ET dimensionality, 32.78% patients have highly bad experiences and 67.22% patients have moderate and highly bad experiences in total plus the patients with moderate scores; in TII dimensionality, 73.88% patients have moderate and highly bad experiences. L ICU and L MV of patients and overall GEI and various factor scores exhibit a significant positive correlation (P<0.05) indicating that the longer the time of mechanical ventilation treatment and length of stay in ICU, the more bad experiences the patients will have; patients' APACHE scores and the overall GEI, dimensionality ET, ACF and TII exhibit a positive correlation (P<0.05) indicating the severer the disease is, the more bad experiences on intensive care the patient will have. Mechanical ventilation duration, disease severity degrees, marital status and age are the major factors influencing intensive care experiences of patients in mechanical ventilation.

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Prognosis of elderly patients subjected to mechanical ventilation in the ICU

Cited by 11 publications

References 29 publications

Clinical characteristics and outcomes of mechanically ventilated elderly patients in intensive care units: a Chinese multicentre retrospective study

Clinical characteristics and outcomes of mechanically ventilated elderly patients in intensive care units: a Chinese multicentre retrospective study

Calculating the Risk Benefit Equation for Aggressive Treatment of Non-convulsive Status Epilepticus

Research on Intensive Care Experiences of Patients in Mechanical Ventilation

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