Criteria of early limitation of transfer in intensive care unit of patients aged 75 and over hospitalized in an acute geriatric unit
| Autor: | Mélanie Dipanda, Sophie Putot, Patrick Manckoundia, Alain Putot, Jérémy Barben, Anca-Maria Mihai, Jérémie Vovelle, Valentine Nuss, Agnès Camus, Caroline Laborde |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis Patients law.invention law Intensive care Humans Medicine Biological Psychiatry Aged Retrospective Studies Aged 80 and over Univariate analysis business.industry Retrospective cohort study Odds ratio medicine.disease Intensive care unit Confidence interval Nursing Homes Hospitalization Intensive Care Units Malnutrition Neuropsychology and Physiological Psychology Emergency medicine Neurology (clinical) Geriatrics and Gerontology business |
| Zdroj: | Gériatrie et Psychologie Neuropsychiatrie du Viellissement. 19:279-286 |
| ISSN: | 1950-6988 1760-1703 |
| DOI: | 10.1684/pnv.2021.0962 |
| Popis: | Because of heterogeneity of the elderly population and medical practices, the decision of admission of elderly patients (EP) in intensive care unit is more complex. This study aimed to determine the decision criteria for an early limitation of transfer in intensive care unit (ELTICU) of patients hospitalized in an acute geriatric unit. This retrospective study included, over a 10-month period, patients ≥75 years and hospitalized in an acute geriatric unit. They were divided into 2 groups according to whether or not an ELTICU decision was taken. In total, 906 EP were included among them 446 with no ELTICU decision. Univariate analysis showed a correlation between ELTICU and a Mini Mental Status score of less than 20/30. Malnutrition had no impact on ELTICU decision. In multivariate analysis, the factors associated with an ELTICU decision were an age ≥ 85 years, an hospitalization in the last 6 months (Odds Ratio (OR) = 1.72, Confidence Interval (CI) 95% [1.23-2.39]), life in a nursing home (OR = 1.93, 95% CI [1.18-3.16]) and the presence of bedsore(s) (OR = 2.44, 95% CI [1.20-4.98]). A null Charlson score was associated with the absence of an ELTICU decision (OR = 0.42, 95% CI [0.26-0.67]). Some criteria are shared between geriatricians, resuscitators and emergency physicians, while others are discordant, illustrating differences in physicians' practices. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|