Document Detail

In-hospital and long-term prognosis of elderly patients requiring endotracheal intubation for life-threatening presentation of cardiogenic pulmonary edema.
MedLine Citation:
PMID:  11373490     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We studied the in-hospital course, long-term prognosis, and functional status of elderly patients with life-threatening cardiogenic pulmonary edema requiring mechanical ventilation. DESIGN: Semiprospective evaluation. SETTING: Twelve intensive care units and one emergency prehospital medical department in university hospitals. PATIENTS: Patients, aged >75 yrs, with life-threatening cardiogenic pulmonary edema requiring invasive airway management during the prehospital phase between January 1994 and January 1999 were included. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 79 patients were studied, of which 55 were included in the prospective phase and 24 during the retrospective phase. The age range was 75-99 yrs, with a mean age of 82.4 +/- 5.9. The male/female ratio was 35:44. The in-hospital mortality was 26.6%. The mean follow-up time for all 58 survivors was 23 months (range, 2-56 months). Among those discharged, survival at 1 yr was 69%. At 3 months after hospital discharge, 49 (87%) patients lived at home, 46 (82%) were able to bathe themselves, 35 (62%) could walk at least one block, and 34 (61%) could climb one flight of stairs. CONCLUSIONS: Mortality after severe pulmonary edema requiring endotracheal intubation in a very elderly cohort has a predictably high mortality, although not related directly to the degree of presenting respiratory compromise. However, approximately 50% of the overall cohort returned to relatively good functional status, despite advanced age and a severely compromised presentation. Aggressive airway management appears, therefore, justified in this select group of patients.
F Adnet; P Le Toumelin; A Leberre; J Minadeo; F Lapostolle; P Plaisance; M Cupa
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  29     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-05-24     Completed Date:  2001-06-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  891-5     Citation Subset:  AIM; IM    
SAMU 93, Hôpital Avicenne, Université Paris XIII, Bobigny Cedex, France.
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MeSH Terms
Aged, 80 and over
Critical Care*
Intensive Care Units
Intubation, Intratracheal*
Length of Stay
Prospective Studies
Pulmonary Edema / mortality,  therapy*
Respiration, Artificial
Retrospective Studies
Treatment Outcome

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