Outcome of older persons admitted to intensive care unit, mortality, prognosis factors, dependency scores and ability trajectory within 1 year: a prospective cohort study
| Autor: | Karim Chaoui, Anne Marie Rullion-Pac Soo, Aissa Kherchache, Patrick Dezou, Philippe Sejourné, Eric Tellier, Claude Level |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Aging medicine.medical_specialty Critical Care medicine.medical_treatment Dependency Psychological Comorbidity law.invention 03 medical and health sciences 0302 clinical medicine law Intensive care medicine Humans Disabled Persons 030212 general & internal medicine Hypoalbuminemia Prospective Studies Survivors Prospective cohort study Geriatric Assessment Aged Mechanical ventilation Aged 80 and over business.industry 030208 emergency & critical care medicine Length of Stay medicine.disease Prognosis Intensive care unit Hospitalization Intensive Care Units SAPS II Emergency medicine Female Geriatrics and Gerontology business Cohort study |
| Zdroj: | Aging clinical and experimental research. 30(9) |
| ISSN: | 1720-8319 |
| Popis: | The outcome and functional trajectory of older persons admitted to intensive care (ICU) unit remain a true question for critical care physicians and geriatricians, due to the heterogeneity of geriatric population, heterogeneity of practices and absence of guidelines. To describe the 1-year outcome, prognosis factors and functional trajectory for older people admitted to ICU. In a prospective 1-year cohort study, all patients aged 75 years and over admitted to our ICU were included according to a global comprehensive geriatric assessment. Follow-up was conducted for 1 year survivors, in particular, ability scores and living conditions. Of 188 patients included [aged 82.3 ± 4.7 years, 46% of admissions, median SAPS II 53.5 (43–74), ADL of Katz’s score 4.2 ± 1.6, median Barthel’s index 71 (55–90), AGGIR scale 4.5 ± 1.5], the ICU, hospital and 1-year mortality were, respectively, 34, 42.5 and 65.5%. Prognosis factors were: SAPS 2, mechanical ventilation, comorbidity (Lee’s and Mc Cabe’s scores), disability scores (ADL of Katz’s score, Barthel’s index and AGGIR scale), admission creatinin, hypoalbuminemia, malignant haemopathy, cognitive impairment. One-year survivors lived in their own home for 83%, with a preserved physical ability, without significant variation of the three ability assessed scores compared to prior ICU admission. The mortality of older people admitted to ICU is high, with a significant impact of disabilty scores, and preserved 1-year survivor independency. Other studies, including a better comprehensive geriatric assessment, seem necessary to determine a predictive “phenotype” of survival with a “satisfactory” level of autonomy. |
| Databáze: | OpenAIRE |
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