Respiratory Emergencies in Geriatric Patients

Tyler, Katren R; Stevenson, Dane

doi:10.1016/j.emc.2015.08.003

Cited by 8 publications

(3 citation statements)

References 37 publications

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“…3À5 In the USA, ARF treatment cost exceeds $50 billion per year due to the high mortality and long LOS, especially for elderly patients. 6,7 Therefore, it is critical to find the causes among elderly patients with ARF to reduce the high mortality and long LOS, hence high medical costs.…”

Section: Introductionmentioning

confidence: 99%

The relationship of the geriatric nutritional risk index to mortality and length of stay in elderly patients with acute respiratory failure: A retrospective cohort study

et al. 2021

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Background: Elderly people with acute respiratory failure (ARF) have prolonged length of hospital stay (LOS) and high mortality rates. Malnutrition is negatively correlated with these LOS and mortality. However, no tools have been used to detect the risk of malnutrition and assist in designing nutritional support for these patients. The geriatric nutritional risk index (GNRI) is reported as a novel tool for evaluating the risk of malnutrition. The aim of this study is to explore the relationship of the GNRI score with mortality and LOS in elderly patients with ARF. Methods: Data of elderly patients diagnosed with ARF were retrieved from the Medical Information Mart for Intensive Care III (MIMIC-III) database. A total of 1250 patients were divided into two groups based on their GNRI score: the malnutrition risk group (GNRI 98) and no risk group (GNRI > 98). The primary endpoints of this study were hospital mortality and hospital LOS. Results: The higher GNRI score was associated with lower hospital mortality and shorter hospital LOS. Odds ratio (OR) for hospital mortality of patients with nutritional risk (GNRI 98) was 1.264 (95% CI:1.067À1.497) in the adjusted model. Patients with GNRI 98 had longer hospital LOS (adjusted OR: 1.142, 95%CI: 1.044À1.250) compared with those with GNRI > 98. Subgroup analysis showed that higher GNRI was only significantly associated with lower hospital mortality in the patients that did not undergo mechanical ventilator (MV) treatment (adjusted OR: 0.985, 95% CI: 0.977À0.992, P < 0.01). Kaplan-Meier curve analysis showed that the 90-day survival was significantly lower in the group with nutrition risk (GNRI98) compared with the no risk group (GNRI > 98, p < 0.05). Conclusion: These findings imply that GNRI is a useful prognostic tool in elderly patients with ARF.

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Section: Introductionmentioning

confidence: 99%

The relationship of the geriatric nutritional risk index to mortality and length of stay in elderly patients with acute respiratory failure: A retrospective cohort study

et al. 2021

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“…A rapid and correct handling and treatment of patients with dyspnea are of the highest priority, as acute dyspnea in itself is a predictor of increased mortality [ 12 ]. Furthermore, different conditions may be at hand simultaneously, especially among elderly patients with a higher risk of comorbid conditions [ 13 ]. A biomarker with the ability to predict survival in patients with dyspnea as well as in patients with diabetes regardless of type is warranted.…”

Section: Discussionmentioning

confidence: 99%

TNFR1 is associated with short-term mortality in patients with diabetes and acute dyspnea seeking care at the emergency department

et al. 2020

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Background Circulating levels of TNF alpha receptor 1 (TNFR1) and 2 (TNFR2) are associated with increased long-term mortality and impaired kidney function. Aim To study association between circulating levels of TNFR1 and TNFR2 and short-term mortality in patients with diabetes and dyspnea. Population and methods Patients aged ≥ 18 years seeking at emergency department (ED) during daytime on weekdays between December 2013 and July 2018, with diabetes and acute dyspnea, identified at the triage process, were included. Participants (n = 291) were triaged according to Medical Emergency Triage and Treatment System-Adult score, and blood samples were collected. Association between TNFR1 and TNFR2, respectively, and 90-day mortality were estimated by Cox regression models adjusted for age, sex, BMI, creatinine and CRP. Results Univariate models showed significant associations between TNFR1 and TNFR2, respectively, and CRP, age and creatinine. TNFR1 and TNFR2 tended to be elevated in patients with the highest triage level, compared to patients with lower triage levels (ns). In longitudinal analyses, TNFR1 but not TNFR2 was associated with increased short-term mortality, HR adjusted for age, BMI and creatinine 1.43 (95% CI 1.07–1.91), but not in the model also adjusted for CRP, HR 1.29 (95% CI 0.94–1.77). In secondary analysis for quartile 4 versus quartiles 1–3 of TNFR1, corresponding HRs were 2.46 (95% CI 1.27–5.15) and 2.21 (95% CI 1.07–2.56). Conclusions We found a trend for the association between circulating TNFR1 levels and short-term mortality in patients with diabetes and acute dyspnea at the ED, possibly suggesting an inflammatory pathway for the association.

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“…46 Age seems to not be a limiting factor for the safe use of ventilatory support; similar results were observed for various age groups. 39,47,48 De novo ARF in immunocompromised elderly patients…”

Section: Acute Heart Failure In Elderly Patientsmentioning

confidence: 99%

Non‐invasive mechanical ventilation in elderly patients: A narrative review

Piroddi¹,

Barlascini²,

Esquinas

et al. 2016

Geriatrics Gerontology Int

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The treatment of acute respiratory failure with non-invasive ventilation (NIV) as a first-line therapy is increasingly common in intensive care units. The reduced invasiveness of NIV leads to better outcomes than endotracheal intubation in carefully selected groups of patients. Furthermore, the use of NIV as a palliative treatment for respiratory failure and dyspnea has become increasingly common. NIV also has an impact on the use of "do not intubate" orders. In the present narrative review, we explore the use and outcome of NIV in elderly patients. To accomplish this, we reviewed the most recent available medical literature. Geriatr Gerontol Int 2017; 17: 689-696.

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Respiratory Emergencies in Geriatric Patients

Cited by 8 publications

References 37 publications

The relationship of the geriatric nutritional risk index to mortality and length of stay in elderly patients with acute respiratory failure: A retrospective cohort study

The relationship of the geriatric nutritional risk index to mortality and length of stay in elderly patients with acute respiratory failure: A retrospective cohort study

TNFR1 is associated with short-term mortality in patients with diabetes and acute dyspnea seeking care at the emergency department

Non‐invasive mechanical ventilation in elderly patients: A narrative review

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