Propensity-Adjusted Comparison of Mortality of Elderly Versus Very Elderly Ventilated Patients.
BACKGROUND: The growing proportion of elderly intensive care patients constitutes a public health challenge. The benefit of critical care in these patients remains unclear. We compared outcomes in elderly versus very elderly subjects receiving mechanical ventilation. METHODS: In total, 5,557 mechani...
| Publicado en: | Respiratory Care Vol. 66; no. 5; pp. 814 - 822 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
May2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=150127064&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 150127064 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: May2021 vid: 66 iid: 5 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 150127064 150127064 150127064 10.4187/respcare.08547 150127064 ppf: 814 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Propensity-Adjusted Comparison of Mortality of Elderly Versus Very Elderly Ventilated Patients. aug: au: Wernly, Bernhard Bruno, Raphael Romano Frutos-Vivar, Fernando Peñuelas, Oscar Rezar, Richard Raymondos, Konstantinos Muriel, Alfonso Bin Du Thille, Arnaud W. Ríos, Fernando González, Marco del-Sorbo, Lorenzo Marín, Maria del Carmen Pinheiro, Bruno Valle Soares, Marco Antonio Nin, Nicolas Maggiore, Salvatore M. Bersten, Andrew Kelm, Malte Amin, Pravin affil: Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria sug: subj: Respiration, Artificial In Old Age Critical Care Evaluation Mortality Risk Factors Treatment Outcomes Risk Assessment Mortality Evaluation Human Aged Post Hoc Analysis Retrospective Design Prospective Studies Aged, 80 and Over Descriptive Statistics Logistic Regression Odds Ratio Confidence Intervals Clinical Assessment Tools Analysis of Variance Multiple Regression Data Analysis Software Age Factors Mortality Survival Aged: 65+ years Aged, 80 & over ab: BACKGROUND: The growing proportion of elderly intensive care patients constitutes a public health challenge. The benefit of critical care in these patients remains unclear. We compared outcomes in elderly versus very elderly subjects receiving mechanical ventilation. METHODS: In total, 5,557 mechanically ventilated subjects were included in our post hoc retrospective analysis, a subgroup of the VENTILA study. We divided the cohort into 2 subgroups on the basis of age: very elderly subjects (age ≥ 80 y; n = 1,430), and elderly subjects (age 65-79 y; n = 4,127). A propensity score on being very elderly was calculated. Evaluation of associations with 28-d mortality was done with logistic regression analysis. RESULTS: Very elderly subjects were clinically sicker as expressed by higher SAPS II scores (53 ± 18 vs 50 ± 18, P < .001), and their rates of plateau pressure < 30 cm H2O were higher, whereas other parameters did not differ. The 28-d mortality was higher in very elderly subjects (42% vs 34%, P < .001) and remained unchanged after propensity score adjustment (adjusted odds ratio 1.31 [95% CI 1.16-1.49], P < .001). CONCLUSIONS: Age was an independent and unchangeable risk factor for death in mechanically ventilated subjects. However, survival rates of very elderly subjects were > 50%. Denial of critical care based solely on age is not justified. (ClinicalTrials.gov registration NCT02731898.) pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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