Study EDEN-12: analysis of access to intensive care units of patients older than 65 years requiring emergency hospitalization

被引：0

作者：

Burillo-Putze, Guillermo ^{[1
]}

Parra-Esquivel, Patricia ^{[2
,3
]}

Aguilo, Sira ^{[4
]}

Jimenez, Sonia ^{[4
]}

Jacob, Javier ^{[5
]}

Pinera Salmeron, Pascual ^{[6
]}

Llorens, Pere ^{[7
]}

Jorge Garcia-Lamberechts, Eric ^{[8
]}

Javier Montero-Perez, Francisco ^{[9
]}

Munoz-Triano, Esperanza ^{[9
]}

Gil-Rodrigo, Adriana ^{[7
]}

Fernandez-Alonso, Cesareo ^{[8
]}

Alquezar-Arbe, Aitor ^{[10
]}

Salido Mota, Manuel ^{[11
]}

Gil Hernandez, Rodrigo Javier ^{[12
]}

Pedraza Garcia, Jorge ^{[13
]}

Cobos Requena, Angela ^{[9
]}

Gargallo Garcia, Esther ^{[14
]}

de Diego Arnaiz, Monica ^{[15
]}

Iglesias Vela, Marta ^{[16
]}

Antonio Perez-Costa, Rafael ^{[17
]}

del Mar Perez Penalva, Sara ^{[18
]}

Valle Borrego, Beatriz ^{[19
]}

Quero Motto, Eva ^{[20
]}

Morales Franco, Belen ^{[21
]}

Adroher Munoz, Maria ^{[22
]}

Gonzalez del Castillo, Juan ^{[8
]}

Miro, Oscar ^{[4
]}

机构：

[1] Univ Europea Canarias, Fac Ciencias Salud, Tenerife, Spain

[2] Hosp Univ Canarias, Serv Urgencias, Tenerife, Spain

[3] Univ La Laguna, Tenerife, Spain

[4] Univ Barcelona, Hosp Clin, IDIBAPS, Area Urgencias, Barcelona, Spain

[5] Hosp Univ Bellvitge, Serv Urgencias, Barcelona, Spain

[6] Hosp Reina Sofia, Serv Urgencias, Murcia, Spain

[7] Univ Miguel Hernandez, Hosp Doctor Balmis Alicante, Inst Invest Sanitaria & Biomed Alicante ISABIAL, Serv Urgencias,Unidad Estancia Corta & Hospitaliza, Alicante, Spain

[8] Univ Complutense, Hosp Clin San Carlos, IDISSC, Serv Urgencias, Madrid, Spain

[9] Hosp Reina Sofia, Serv Urgencias, Cordoba, Spain

[10] Hosp Santa Creu i St Pau, Serv Urgencias, Barcelona, Spain

[11] Hosp Reg Malaga, Serv Urgencias, Malaga, Spain

[12] Hosp Santa Barbara, Serv Urgencias, Soria, Spain

[13] Hosp Valle Pedroches, Serv Urgencias, Cordoba, Spain

[14] Hosp Univ Gregorio Maranon, Serv Urgencias, Madrid, Spain

[15] Hosp Univ Burgos, Serv Urgencias, Burgos, Spain

[16] Complejo Asistencial Univ Leon, Serv Urgencias, Leon, Spain

[17] Hosp Univ Morales Meseguer, Serv Urgencias, Murcia, Spain

[18] Hosp Francecs Borja, Serv Urgencias, Gandia, Valencia, Spain

[19] Hosp Univ Severo Ochoa, Serv Urgencias, Leganes, Madrid, Spain

[20] Hosp Univ Virgen Arrixaca, Serv Urgencias, Murcia, Spain

[21] Hosp Univ Lorenzo Guirao, Serv Urgencias, Murcia, Spain

[22] Hosp Univ Girona Dr Josep Trueta, Serv Urgencias, Girona, Spain

来源：

MEDICINA INTENSIVA | 2023年 / 47卷 / 11期

关键词：

Critical care; Emergency medicine; Aged; Admission; Emergency Department; SPANISH INVESTIGATORS; SITUATIONS TEAM; DECISION-MAKING; DEPARTMENTS; ADMISSION; RECOMMENDATIONS; MORTALITY; CRITERIA; SIESTA;

D O I：

10.1016/j.medin.2023.04.006

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: To investigate the relationship between the age of an urgently hospitalized patient and his or her probability of admission to an intensive care unit (ICU).Design: Observational, retrospective, multicenter study.Setting: 42 Emergency Departments from Spain. Time-period: April, 1 to 7, 2019.Patients: Patients aged >= 65 years hospitalized from spanish emergency departments. Interventions: None.Main variables of interest: ICU admission, age sex, comorbidity, functional dependence and cognitive impairment.Results: 6120 patients were analyzed (median age: 76 years; males: 52%. 309 (5%) were admit-ted to ICU (186 from ED, 123 from hospitalization). Patients admitted to the ICU were younger, male, and with less comorbidity, dependence and cognitive impairment, but there were no differences between those admitted from the ED and from hospitalization. The OR for ICU-admission adjusted by sex, comorbidity, dependence and dementia reached statistical significance>83 years (OR: 0.67; 95%CI: 0.45-0.49). In patients admitted to the ICU from ED, the OR did not begin to decrease until 79 years, and was significant>85 years (OR:0.56, 95%CI: 0.34-0.92); while in those admitted to ICU from hospitalization, the decrease began 65 years of age, and were significant from 85 years (OR:0.55, 95%CI: 0.30-0.99). Sex, comorbidity, dependency and cognitive deterioration of the patient did not modify the association between age and ICU-admission (overall, from the ED or hospitalization).Conclusions: After taking into account other factors that influence admission to the ICU (comorbidity, dependence, dementia), the chances of admission to the ICU of older patients hospitalized on an emergency basis begin to decrease significantly after 83 years of age. There may be differences in the probability of admission to the ICU from the ED or from hospitalization according to age.(c) 2023 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.

引用

页码：638 / 647

页数：10

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