Peri-interventional outcome study in the elderly in Europe A 30-day prospective cohort study

被引：28

作者：

Coburn, Mark ^{[1
]}

Berger, Marc ^{[1
]}

Farcher, Helmut ^{[1
]}

Opperer, Mathias ^{[1
]}

Adriaensens, Ine ^{[1
]}

Saldien, Vera ^{[1
]}

Berghmans, Johan ^{[1
]}

Van Hove, Sofie ^{[1
]}

Beran, Maud ^{[1
]}

Eerdekens, Gert-Jan ^{[1
]}

Mesotten, Dieter ^{[1
]}

Timmers, Maxim ^{[1
]}

Vandermeulen, Elly ^{[1
]}

De Bruyne, Ann ^{[1
]}

De Hert, Stefan ^{[1
]}

De Ruyter, Hendrik ^{[1
]}

Van Belleghem, Vincent ^{[1
]}

Boscart, Isabelle ^{[1
]}

De Corte, Wouter ^{[1
]}

Desmet, Matthias ^{[1
]}

Missant, Carlo ^{[1
]}

Carlier, Stefaan ^{[1
]}

Castelain, Charlotte ^{[1
]}

Demeyer, Caroline ^{[1
]}

Vandenbossche, Carl ^{[1
]}

Missant, Carlo ^{[1
]}

Detienne, Hans ^{[1
]}

Devroe, Sarah ^{[1
]}

Dewinter, Geertrui ^{[1
]}

Hoogma, Danny ^{[1
]}

Huygens, Christel ^{[1
]}

Meeusen, Roselien ^{[1
]}

Rex, Steffen ^{[1
]}

Van de Velde, Marc ^{[1
]}

Lebrun, Christophe ^{[1
]}

Poels, Stephanie ^{[1
]}

Soetens, Filiep ^{[1
]}

Fenger-Eriksen, Christian ^{[1
]}

Draegert, Christina ^{[1
]}

Santos, Sofia Gaspar ^{[1
]}

Soelling, Christine ^{[1
]}

Steinmetz, Jacob ^{[1
]}

Andersen, Gertrud ^{[1
]}

Dalso, Sille Molvig ^{[1
]}

Haderslev, Pernille ^{[1
]}

Rasmussen, Vibe Maria ^{[1
]}

Vester-Andersen, Morten ^{[1
]}

Sommer, Tine Gjedde ^{[1
]}

Kirkegaard, Johan ^{[1
]}

Lundstrom, Lars H. ^{[1
]}

机构：

[1] Univ Hosp Bonn, Dept Anaesthesiol & Intens Care Med, D-53127 Bonn, Germany

来源：

EUROPEAN JOURNAL OF ANAESTHESIOLOGY | 2022年 / 39卷 / 03期

关键词：

PREOPERATIVE ASSESSMENT; SURGICAL OUTCOMES; MORTALITY; SURGERY; FRAILTY; DERIVATION; PATIENT; OLDER;

D O I：

10.1097/EJA.0000000000001639

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

OBJECTIVES The aim of this study was to describe the 30-day mortality rate of patients aged 80 years and older undergoing surgical and nonsurgical procedures under anaesthesia in Europe and to identify risk factors associated with mortality.DESIGN A prospective cohort study.SETTING European multicentre study, performed from October 2017 to December 2018. Centres committed to a 30-day recruitment period within the study period.PATIENTS Nine thousand four hundred and ninety-seven consecutively recruited patients aged 80 years and older undergoing any kind of surgical or nonsurgical procedures under anaesthesia.MAIN OUTCOME MEASURES The primary outcome was all-cause mortality within 30 days after procedure described by Kaplan-Meier curves with 95% CI. Risk factors for 30-day mortality were analysed using a Cox regression model with 14 fixed effects and a random centre effect.RESULTS Data for 9497 patients (median age, 83.0 years; 52.8% women) from 177 academic and nonacademic hospitals in 20 countries were analysed. Patients presented with multimorbidity (77%), frailty (14%) and at least partial functional dependence (38%). The estimated 30-day mortality rate was 4.2% (95% CI 3.8 to 4.7). Among others, independent risk factors for 30-day mortality were multimorbidity, hazard ratio 1.87 (95% CI 1.26 to 2.78), frailty, hazard ratio 2.63 (95% CI 2.10 to 3.30), and limited mobility, hazard ratio 2.19 (95% CI 1.24 to 3.86). The majority of deaths (76%) occurred in hospital. Mortality risk for unplanned ICU admission was higher, hazard ratio 3.57 (95% CI 2.38 to 5.26) than for planned ICU admission, hazard ratio 1.92 (95% CI 1.47 to 2.50). Compared with other studies, the in-hospital complication rates of 17.4 and 3.9% after discharge were low. Admission to a unit with geriatric care within 30 days after the intervention was associated with a better survival within the first 10 days.CONCLUSIONS The estimated 30-day mortality rate of 4.2% was lower than expected in this vulnerable population.

引用

页码：198 / 209

页数：12

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