| Increased intensity of treatment and decreased mortality in elderly patients in an intensive care unit over a decade. | |
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MedLine Citation:
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PMID: 19633539 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Data collected from two cohorts of patients aged > or =80 yrs and admitted to an intensive care unit in France were compared to determine whether intensive care unit care and survival had evolved from the 1990s to the 2000s. DESIGN: Retrospective cohort study on patient data attained during intensive care unit stays. SETTING: 18-bed intensive care unit in an academic medical center. PATIENTS: Two cohorts of patients aged > or =80 yrs, admitted to an intensive care unit at a 10-yr interval. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The first cohort comprised 348 patients admitted between January 1992 and December 1995, and the second cohort, 373 patients admitted between January 2001 and December 2004. There was no difference in age between the two cohorts, but patients in the second had significantly less history of functional limitation and significantly more acute illness (Simplified Acute Physiology Score II 43 +/- 18 vs. 57 +/- 25, respectively, p < .0001). Patients in the second cohort had a significantly higher Omega Score, had a higher occurrence of renal replacement therapy, and received vasopressors more frequently than the patients in the first cohort, even when adjusted for age, sex, Knaus classification, Simplified Acute Physiology Score II, and intensive care unit admission cause. Intensive care unit mortality was 65% and 64% for the first and second cohorts, respectively. In multivariate analysis (including age, Knaus classification, Simplified Acute Physiology Score II and first vs. second period) for association with intensive care unit survival, the 2001-2004 period was associated with a near tripling of chances of survival (odds ratio 2.9; 95% confidence interval, 1.92-4.47, p < .0001). CONCLUSIONS: The characteristics and intensity of treatment for elderly people admitted to the intensive care unit changed significantly over a decade. The intensity of treatments has increased over time and survival has improved over time as well. A potential link between increased treatment and improved survival in the elderly may be evoked. |
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Authors:
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Nicolas Lerolle; Ludovic Trinquart; Caroline Bornstain; Jean-Marc Tadié; Audrey Imbert; Jean-Luc Diehl; Jean-Yves Fagon; Emmanuel Guérot |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 38 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-22 Completed Date: 2010-01-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 59-64 Citation Subset: AIM; IM |
Affiliation:
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Service de Réanimation Médicale, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France. nicolas.lerolle@egp.aphp.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged, 80 and over Cause of Death Chi-Square Distribution Cohort Studies Combined Modality Therapy Female Follow-Up Studies Geriatric Assessment Health Care Surveys Hospital Mortality / trends* Hospitals, University Humans Intensive Care / trends* Intensive Care Units / utilization* Length of Stay / statistics & numerical data* Male Retrospective Studies Risk Assessment Statistics, Nonparametric Survival Analysis Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2010 Jan;38(1):303-4
[PMID:
20023472
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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