| Autor: |
Pietiläinen, Laura, Hästbacka, Johanna, Bäcklund, Minna, Pettilä, Ville, Parviainen, Ilkka, Reinikainen, Matti |
| Předmět: |
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| Zdroj: |
Intensive Care Medicine; Aug2018, Vol. 44 Issue 8, p1221-1229, 9p, 3 Charts, 2 Graphs |
| Abstrakt: |
Purpose: We assessed the association between the premorbid functional status (PFS) and 1-year mortality and functional status of very old intensive care patients.Methods: Using a nationwide quality registry, we retrieved data on patients treated in Finnish intensive care units (ICUs) during the period May 2012‒April 2013. Of 16,389 patients, 1827 (11.1%) were very old (aged 80 years or older). We defined a person with good functional status as someone independent in activities of daily living (ADL) and able to climb stairs without assistance; a person with poor functional status was defined as needing assistance for ADL or being unable to climb stairs. We adjusted for severity of illness and calculated the impact of PFS.Results: Overall, hospital mortality was 21.3% and 1-year mortality was 38.2%. For emergency patients (73.5% of all), hospital mortality was 28% and 1-year mortality was 48%. The functional status at 1 year was comparable to the PFS in 78% of the survivors. PFS was poor for 43.3% of the patients. A poor PFS predicted an increased risk of in-hospital death, adjusted odds ratio (OR) 1.50 (95% confidence interval, 1.07-2.10), and of 1-year mortality, OR 2.18 (1.67-2.85). PFS data significantly improved the prediction of 1-year mortality.Conclusions: Of very old ICU patients, 62% were alive 1 year after ICU admission and 78% of the survivors had a functional status comparable to the premorbid situation. A poor PFS doubled the odds of death within a year. Knowledge of PFS improved the prediction of 1-year mortality. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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