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Long-term survival of elderly patients after intensive care unit admission for acute respiratory infection: a population-based, propensity score-matched cohort study.
- Source :
-
Critical care (London, England) [Crit Care] 2020 Jun 29; Vol. 24 (1), pp. 384. Date of Electronic Publication: 2020 Jun 29. - Publication Year :
- 2020
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Abstract
- Background: Intensive care unit (ICU) hospitalisations of elderly patients with acute respiratory infection have increased, yet the long-term effects of ICU admission among elderly individuals remain unknown. We examined differences over the 2 years after discharge in mortality, healthcare utilisation and frailty score between elderly survivors of ARI in the ICU and an elderly control population.<br />Methods: We used 2009-2017 data from 39 hospital discharge databases. Patients ≥ 80 years old discharged alive from ICU hospitalisation for acute respiratory infection were propensity score-matched with controls (cataract surgery) discharged from the hospital at the same time and adjusted for age, sex and comorbidities present before hospitalisation. We reported 2-year mortality and compared healthcare utilisation and frailty scores in the 2-year periods before and after ICU hospitalisation.<br />Results: One thousand two hundred and twenty elderly survivors of acute respiratory infection in the ICU were discharged, and 988 were successfully matched with controls. After discharge, patients had a 10.1-fold [95% CI, 6.1-17.3] higher risk of death at 6 months and 3.6-fold [95% CI, 2.9-4.6] higher risk of death at 2 years compared with controls. They also had a 2-fold increase in both healthcare utilisation and frailty score in the 2 years after hospital discharge, whereas healthcare utilisation and frailty scores among controls were stable before and after hospitalisation.<br />Conclusions: We observed a substantially increased rate of death in the years following ICU hospitalisation for elderly patients along with elevated healthcare resource use and accelerated age-associated decline as assessed by frailty score. These findings provide data for better informed goals-of-care discussions and may help target post-ICU discharge services.
- Subjects :
- Aged
Aged, 80 and over
Cohort Studies
Female
France epidemiology
Hospitalization statistics & numerical data
Humans
Intensive Care Units organization & administration
Intensive Care Units statistics & numerical data
Kaplan-Meier Estimate
Length of Stay statistics & numerical data
Male
Patient Admission trends
Propensity Score
Proportional Hazards Models
Qualitative Research
Respiratory Tract Infections epidemiology
Patient Admission statistics & numerical data
Respiratory Tract Infections mortality
Survivors statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1466-609X
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Critical care (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 32600392
- Full Text :
- https://doi.org/10.1186/s13054-020-03100-4