Pronóstico de los ancianos ventilados mecánicamente en la UCI

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.medin.2012.03.014

Cited by 16 publications

(8 citation statements)

References 29 publications

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“…[41] Another study, which included 1661 patients treated with MV in Spain, also found that older patients (≥75 years) had a significantly higher ICU mortality than younger patients without any differences in the duration MV. [42] Consistent with the above research, studies conducted in the USA [5] and Brazil [43] also concluded that age was an independent predictor of mortality in patients given MV. An advantage of the present study was that the sample size was sufficiently large to allow a stratified analysis of the factors affecting survival in patients receiving MV in the ICU.…”

Section: Discussionsupporting

confidence: 57%

Prognostic factors associated with mortality in mechanically ventilated patients in the intensive care unit

Liang¹,

Li²,

Dong³

et al. 2019

Medicine

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Data on outcomes of patients receiving mechanical ventilation (MV) in China are scarce.To investigate factors associated with the prognosis of patients given MV in the intensive care unit (ICU).A 12-year (January 1, 2006–December 31, 2017) retrospective cohort study.ICU of Beijing Geriatric Hospital, China.A total of 905 patients aged ≥16 years given MV during the study period.None.Among 905 patients included (610 men; median age, 78 years; Acute Physiology and Chronic Health Evaluation [APACHE]-II score, 27.3 ± 8.9), 585 survived (388 men; median age, 77 years; average APACHE-II score, 25.6 ± 8.4), and 320 died in the ICU (222 men; median age, 78 years; APACHE-II score, 30.6 ± 8.9). All-cause ICU mortality was 35.4%. In patients aged <65 years, factors associated with ICU mortality were APACHE-II score (odds ratio [OR], 1.108; 95% confidence interval [95% CI], 1.021–1.202; P = .014), nosocomial infection (OR, 6.618; 95% CI, 1.065–41.113; P = .043), acute kidney injury (OR, 17.302; 95% CI, 2.728–109.735; P = .002), invasive hemodynamic monitoring (OR, 10.051; 95% CI, 1.362–74.191; P = .024), MV for cardiopulmonary resuscitation (OR, 0.122; 95% CI, 0.016–0.924; P = .042), duration of MV (OR, 0.993; 95% CI, 0.988–0.998; P = .008), successful weaning from MV (OR, 0.012; 95% CI, 0.002–0.066; P < .001), and renal replacement therapy (OR, 0.039; 95% CI, 0.005–0.324; P = .003). In patients aged ≥65 years, factors associated with mortality were APACHE-II score (OR, 1.062; 95% CI, 1.030–1.096; P < .001), nosocomial infection (OR, 2.427; 95% CI, 1.359–4.334; P = .003), septic shock (OR, 2.017; 95% CI, 1.153–3.529; P = .014), blood transfusion (OR, 1.939; 95% CI, 1.174–3.202; P = .010), duration of MV (OR, 0.999; 95% CI, 0.999–1.000; P = .043), and successful weaning from MV (OR, 0.027; 95% CI, 0.015–0.047; P < .001).APACHE-II score, successful weaning, and nosocomial infection in the ICU are independently associated with the prognosis of patients given MV in the ICU.

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Section: Discussionsupporting

confidence: 57%

Prognostic factors associated with mortality in mechanically ventilated patients in the intensive care unit

Liang¹,

Li²,

Dong³

et al. 2019

Medicine

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“…Of the 189 patients, almost all of whom were older adults, 50.8% were given vasoactive drugs and 56.6% underwent invasive mechanical ventilation. Mechanical ventilation is associated with higher mortality, especially in individuals over 75 years of age (20) .…”

Section: Discussionmentioning

confidence: 99%

Level of acuity, severity and intensity of care of adults and older adults admitted to the Intensive Care Unit

Ferretti‐Rebustini

Bispo²,

Alves

et al. 2019

Rev. esc. enferm. USP

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Objective: To characterize the level of acuity, severity and intensity of care of adults and older adults admitted to Intensive Care Units and to identify the predictors of severity with their respective predictive capacity according to the age group. Method: A retrospective cohort based on the analysis of medical records of individuals admitted to eight adult intensive care units in the city of São Paulo. The clinical characteristics at admission in relation to severity profile and intensity of care were analyzed through association and correlation tests. The predictors were identified by linear regression and the predictive capacity through the ROC curve. Results: Of the 781 cases (41.1% from older adults), 56.2% were males with a mean age of 54.1 ± 17.3 years. The burden of the disease, the organic dysfunction and the number of devices were the predictors associated with greater severity among adults and older adults, in which the organic dysfunction had the highest predictive capacity (80%) in both groups. Conclusion: Adults and older adults presented a similar profile of severity and intensity of care in admission to the Intensive Care Unit. Organic dysfunction was the factor with the best ability to predict severity in adults and older adults.

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“…Both experience and the medical literature available confirm that not only age, but also diseases defined by a low level of conscience, and many other factors can reduce the possibilities of exceeding prolonged courses on mechanical ventilation. 17 , 18 Just as an example, age and comorbidities are two factors that are taken into consideration during the selection of candidates eligible to receive trasplants. 19 , 20 Actually this criterion is not considered utilitarian and is widely accepted by all.…”

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confidence: 99%