| End-stage renal disease status and critical illness in the elderly. | |
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MedLine Citation:
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PMID: 21127136 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: Elderly patients (> 65 years old) are a rapidly growing demographic in the ESRD and intensive care unit (ICU) populations, yet the effect of ESRD status on critical illness in elderly patients remains unknown. Reliable estimates of prognosis would help to inform care and management of this frail and vulnerable population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The effect of ESRD status on survival and readmission rates was examined in a retrospective cohort of 14,650 elderly patients (>65 years old) admitted to 11 ICUs in Winnipeg, Manitoba, Canada between 2000 and 2006. Logistic regression models were used to adjust odds of mortality and readmission to ICU for baseline case mix and illness severity. RESULTS: Elderly ESRD patients had twofold higher crude in-hospital mortality (22% versus 13%, P < 0.0001) and readmission rate (6.4 versus 2.7%, P = 0.001). After adjustment for illness severity alone or illness severity and case mix, the odds ratio for mortality decreased to 0.85 (95% CI: 0.57 to 1.25) and 0.82 (95% CI: 0.55 to 1.23), respectively. In contrast, ESRD status remained significantly associated with readmission to ICU after adjustment for other risk factors (OR 2.06 [95% CI: 1.32, 3.22]). CONCLUSIONS: Illness severity on admission, rather than ESRD status per se, appears to be the main driver of in-hospital mortality in elderly patients. However, ESRD status is an independent risk factor for early and late readmission, suggesting that this population might benefit from alternative strategies for ICU discharge. |
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Authors:
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Manish M Sood; Dan Roberts; Paul Komenda; Joe Bueti; Martina Reslerova; Julie Mojica; Claudio Rigatto |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2010-12-02 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 6 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-17 Completed Date: 2011-06-30 Revised Date: 2012-09-19 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 613-9 Citation Subset: IM |
Affiliation:
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Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Aged, 80 and over Aging* Analysis of Variance Chi-Square Distribution Critical Illness Female Hospital Mortality Humans Intensive Care Units / statistics & numerical data* Kidney Failure, Chronic / diagnosis, mortality*, therapy Logistic Models Male Manitoba / epidemiology Odds Ratio Patient Readmission / statistics & numerical data* Prognosis Retrospective Studies Risk Assessment Risk Factors Severity of Illness Index Survival Analysis Time Factors |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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