ICU-Mortality in Old and Very Old Patients Suffering From Sepsis and Septic Shock

被引：14

作者：

Bruno, Raphael Romano ^{[1
]}

Wernly, Bernhard ^{[2
,3
,4
]}

Mamandipoor, Behrooz ^{[5
]}

Rezar, Richard ^{[3
]}

Binneboessel, Stephan ^{[1
]}

Baldia, Philipp Heinrich ^{[1
]}

Wolff, Georg ^{[1
]}

Kelm, Malte ^{[1
]}

Guidet, Bertrand ^{[6
,7
,8
]}

De Lange, Dylan W. ^{[9
]}

Dankl, Daniel ^{[2
]}

Kokoefer, Andreas ^{[2
]}

Danninger, Thomas ^{[2
]}

Szczeklik, Wojciech ^{[10
]}

Sigal, Sviri ^{[11
]}

van Heerden, Peter Vernon ^{[12
]}

Beil, Michael ^{[11
]}

Fjolner, Jesper ^{[13
]}

Leaver, Susannah ^{[14
]}

Flaatten, Hans ^{[15
]}

Osmani, Venet ^{[5
]}

Jung, Christian ^{[1
]}

机构：

[1] Heinrich Heine Univ Dusseldorf, Univ Hosp Dusseldorf, Med Fac, Div Cardiol Pulmonol & Vasc Med, Dusseldorf, Germany

[2] Paracelsus Med Univ Salzburg, Dept Anesthesiol Perioperat Med & Intens Care Med, Salzburg, Austria

[3] Paracelsus Med Univ Salzburg, Ctr Publ Hlth & Healthcare Res, Salzburg, Austria

[4] Paracelsus Med Univ Salzburg, Dept Cardiol, Salzburg, Austria

[5] Fdn Bruno Kessler Res Inst, Trento, Italy

[6] Hop St Antoine, Hop Paris, Serv Reanimat Med, Paris, France

[7] UPMC Univ Paris 06, Sorbonne Univ, UMR S 1136, Inst Pierre Louis Epidemiol & Sante Publ, Paris, France

[8] INSERM, UMR S 1136, Inst Pierre Louis Epidemiol & Sante Publ, Paris, France

[9] Univ Utrecht, Univ Med Ctr, Dept Intens Care Med, Utrecht, Netherlands

[10] Jagiellonian Univ, Intens Care & Perioperat Med Div, Med Coll, Krakow, Poland

[11] Hadassah Univ Hosp, Med Intens Care Unit, Jerusalem, Israel

[12] Hadassah Univ Hosp, Gen Intens Care Unit, Jerusalem, Israel

[13] Aarhus Univ Hosp, Dept Intens Care, Aarhus, Denmark

[14] St George Hosp, Crit Care Directorate, London, England

[15] Haukeland Hosp, Dept Intens Care Anesthesia & Surg Serv, Bergen, Norway

来源：

FRONTIERS IN MEDICINE | 2021年 / 8卷

关键词：

sepsis; intensive care; critically ill; obesity; old; very old; octogenarian; geriatric; INTENSIVE-CARE-UNIT; ELDERLY-PATIENTS; IMPACT; PROGNOSTICATION; ADMISSION; TRIAGE; ETHICA;

D O I：

10.3389/fmed.2021.697884

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose: Old (>64 years) and very old (>79 years) intensive care patients with sepsis have a high mortality. In the very old, the value of critical care has been questioned. We aimed to compare the mortality, rates of organ support, and the length of stay in old vs. very old patients with sepsis and septic shock in intensive care. Methods: This analysis included 9,385 patients, from the multi-center eICU Collaborative Research Database, with sepsis; 6184 were old (aged 65-79 years), and 3,201 were very old patients (aged 80 years and older). A multi-level logistic regression analysis was used to fit three sequential regression models for the binary primary outcome of ICU mortality. A sensitivity analysis in septic shock patients (n = 1054) was also conducted. Results: In the very old patients, the median length of stay was shorter (50 +/- 67 vs. 56 +/- 72 h; p < 0.001), and the rate of a prolonged ICU stay was lower (>168 h; 9 vs. 12%; p < 0.001) than the old patients. The mortality from sepsis was higher in very old patients (13 vs. 11%; p = 0.005), and after multi-variable adjustment being very old was associated with higher odds for ICU mortality (aOR 1.32, 95% CI 1.09-1.59; p = 0.004). In patients with septic shock, mortality was also higher in the very old patients (38 vs. 36%; aOR 1.50, 95% CI 1.10-2.06; p = 0.01). Conclusion: Very old ICU-patients suffer from a slightly higher ICU mortality compared with old ICU-patients. However, despite the statistically significant differences in mortality, the clinical relevance of such minor differences seems to be negligible.

引用

页数：10

共 49 条

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