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KMID : 1144420220370030372
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Acute and Critical Care
2022 Volume.37 No. 3 p.372 ~ p.381
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Characteristics and prognostic factors of very elderly patients admitted to the intensive care unit
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Lee Song-I
Koh Youn-Suck
Huh Jin-Won
Hong Sang-Bum
Lim Chae-Man
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Abstract
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Background: Korea is rapidly becoming a super aging society and is facing the increased burden of critical care for the elderly people. Traditionally, far-advanced age has been regarded as a triage criterion for intensive care unit (ICU) admission. We evaluated how the characteristics and prognostic factors of very elderly patients (≥85 years) admitted to the ICU changed over the last decade.
Methods: We retrospectively evaluated the data of patients admitted to the ICU over 11 years (2007?2017). The clinical characteristics and outcomes of the very elderly-patients group were evaluated. Factors associated with mortality were assessed by a cox regression analysis.
Results: Comparing the first half (2007?2012) and the second half (2013?2017) of the study period, the proportion of very elderly group increased from 603/47,657 (1.3%), to 697/37,756 (1.8%) (P<0.001). Among 1,294 very elderly patients, 1,274 patients were analyzed excluding hopeless discharge (n=20). The non-surgical reasons for ICU admission (67.0% vs. 76.1%, P<0.001) and the percentage of patients with co-morbidities (78.3% vs. 82.7%, P=0.048) were increased. Nevertheless, the hospital mortality decreased (21.3% vs. 14.9%, P=0.001). High creatinine levels, use of vasopressors and ventilator weaning failure were associated with in-hospital mortality.
Conclusions: The proportion of very elderly people in the ICU increased over the last decade. The non-surgical causes of ICU admission increased compared with the surgical causes. Despite an increasement in ICU admissions of very elderly patients, in-hospital mortality of very elderly ICU patients decreased.
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KEYWORD
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aging society, critical care, mortality, very elderly
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