Prognostic factors associated with six month mortality of critically ill elderly patients admitted to the intensive care unit with severe acute cholangitis
| Autor: | Emmanuel Novy, Lucie Carrara, Jean-Baptiste Chevaux, Thomas Remen, Guillaume Louis, Philippe Guerci, Marie-Reine Losser |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis Cholangitis Critical Illness law.invention 03 medical and health sciences 0302 clinical medicine law Intensive care medicine Humans Hospital Mortality Retrospective Studies Aged 80 and over Hepatology business.industry Mortality rate Gastroenterology Retrospective cohort study Prognosis medicine.disease Intensive care unit Intensive Care Units Malnutrition SAPS II 030220 oncology & carcinogenesis Emergency medicine Female 030211 gastroenterology & hepatology SOFA score business |
| Zdroj: | HPB. 23:459-467 |
| ISSN: | 1365-182X |
| Popis: | Background Little is known about the outcomes of elderly patients admitted to the intensive care unit (ICU) with severe acute cholangitis (SAC). The objectives were to describe the 6-month mortality in patients with SAC ≥75 years and to identify factors associated with this mortality. Methods Bi-center retrospective study of critically ill elderly patients with SAC conducted between 2013 and 2017. Demographic and clinical variables of ICU and hospital stays with a 6-month follow-up were analyzed. Results 85 patients, with a median [Q1–Q3] age of 83 [80–89] years were enrolled of whom 51 (60%) were men. SAC was due to choledocholithiasis in 72 (85%) patients. Median [Q1–Q3] ICU length of stay was 3 [2–6] days. Median [Q1–Q3] admission SAPS II was 50 [42–70]. The ICU and 6-month mortality rates were 18% and 48% respectively. Multivariate analysis showed that malnutrition (OR = 34.5, 95% CI [1.4–817.9]) and a decrease in SOFA score at 48 h (OR by unit 0.7, 95% CI [0.5–0.9]) were associated with higher 6-month mortality. Conclusion In their decision-making process, ICU physicians and hepato-pancreato-biliary surgeons could use these data to estimate the probability of survival of an elderly patient presenting with SAC and to offer time-limited trials of intensive care. Trial registration NCT03831529. |
| Databáze: | OpenAIRE |
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