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Treatment limitations and clinical outcomes in critically ill frail patients with and without COVID‐19 pneumonitis.
- Source :
- Journal of the American Geriatrics Society; Jan2023, Vol. 71 Issue 1, p145-156, 12p
- Publication Year :
- 2023
-
Abstract
- Background: The presence of treatment limitations in patients with frailty at intensive care unit (ICU) admission is unknown. We aimed to evaluate the presence and predictors of treatment limitations in patients with and without COVID‐19 pneumonitis in those admitted to Australian and New Zealand ICUs. Methods: This registry‐based multicenter, retrospective cohort study included all frail adults (≥16 years) with documented clinical frailty scale (CFS) scores, admitted to ICUs with admission diagnostic codes for viral pneumonia or acute respiratory distress syndrome (ARDS) over 2 years between January 01, 2020 and December 31, 2021. Frail patients (CFS ≥5) coded as having viral pneumonitis or ARDS due to COVID‐19 were compared to those with other causes of viral pneumonitis or ARDS for documented treatment limitations. Results: 884 frail patients were included in the final analysis from 129 public and private ICUs. 369 patients (41.7%) had confirmed COVID‐19. There were more male patients in COVID‐19 (55.3% vs 47.0%; p = 0.015). There were no differences in age or APACHE‐III scores between the two groups. Overall, 36.0% (318/884) had treatment limitations, but similar between the two groups (35.8% [132/369] vs 36.1% [186/515]; p = 0.92). After adjusting for confounders, increasing frailty (OR = 1.72; 95%‐CI 1.39–2.14), age (OR = 1.05; 95%‐CI 1.04–1.06), and presence of chronic respiratory condition (OR = 1.58; 95%‐CI 1.10–2.27) increased the likelihood of instituting treatment limitations. However, the presence of COVID‐19 by itself did not influence treatment limitations (odds ratio [OR] = 1.39; 95%‐CI 0.98–1.96). Conclusions: The proportion of treatment limitations was similar in patients with frailty with or without COVID‐19 pneumonitis at ICU admission. [ABSTRACT FROM AUTHOR]
- Subjects :
- ADULT respiratory distress syndrome treatment
INTENSIVE care units
VIRAL pneumonia
RESEARCH
LENGTH of stay in hospitals
VASOCONSTRICTORS
THERAPEUTICS
FRAIL elderly
COVID-19
CONFIDENCE intervals
CRITICALLY ill
MULTIVARIATE analysis
PATIENTS
RETROSPECTIVE studies
MANN Whitney U Test
RENAL replacement therapy
APACHE (Disease classification system)
TREATMENT effectiveness
T-test (Statistics)
HOSPITAL mortality
ARTIFICIAL respiration
DESCRIPTIVE statistics
ODDS ratio
LOGISTIC regression analysis
DATA analysis software
LONGITUDINAL method
EVALUATION
Subjects
Details
- Language :
- English
- ISSN :
- 00028614
- Volume :
- 71
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Journal of the American Geriatrics Society
- Publication Type :
- Academic Journal
- Accession number :
- 161471864
- Full Text :
- https://doi.org/10.1111/jgs.18044