Accès ouvert déclaré
2021
article
Management and outcomes in critically ill nonagenarian versus octogenarian patients
Bernhard Wernly, Malte Kelm, Ariane Boumendil, Alessandro Morandi, Finn H. Andersen, Antonio Artigas, Stefano Finazzi, Maurizio Cecconi, Steffen Christensen, Loredana Faraldi, Michael Lichtenauer, Johanna M. Muessig, Brian Marsh, Rui P. Moreno, Christina Agvald Öhman, Bernardo Bollen Pinto, Ivo W. Soliman, Wojciech Szczeklik, Andreas Valentin, Ximena Watson, Susannah Leaver, Carole Boulanger, Sten Walther, Joerg C. Schefold, Michael Joannidis, Yuriy Nalapko, Muhammed Elhadi, Jesper Fjølner, Tilemachos Zafeiridis, Hans Flaatten, Christian Jung, Philipp Eller, Raimund Helbok, René Schmutz, Joke Nollet, Nikolaas De Neve, Pieter De Buysscher, Walter Swinnen, Marijana Mikačić, Anders Bastiansen, Andreas Husted, Bård E S Dahle, Christine Cramer, Christoffer Sølling, Dorthe Ørsnes, Jakob Edelberg Thomsen, Mathilde Hummelmose Enevoldsen, Thomas Elkmann, Agnieszka Kubisz-Pudelko, Alan Pope, Amy Collins, Ashok Raj, Christian Frey, Ciaran Hart, Clare Bolger, Dominic W. K. Spray, Georgina Randell, Hélder Mota‐Filipe, Ingeborg Welters, Irina Grecu, Jane C. Evans, Jason Cupitt, Jenny Lord, Jeremy Henning, Joanne Jones, Jonathan Ball, Julie North, Kiran Salaunkey, Laura Ortiz-Ruiz de Gordoa, Louise Bell, Madhu Balasubramaniam, Marcela P. Vizcaychipi, Maria Faulkner, M Mupudzi, Megan Lea-Hagerty, Michael Reay, Michael Z. Spivey, Nicholas Love, Nick Spittle Nick Spittle, Nigel White, Patricia Williams, Patrick Morgan, Phillipa Wakefield, Rachel Savine, Reni Jacob, Richard Innes, Ritoo Kapoor, Sally Humphreys, Steve Rose, Susan Dowling, Tarkeshwari Mane, Tom Lawton, Vongayi Ogbeide, Waqas Khaliq, Yolanda Baird, Antoine Romen, Arnaud Galbois, Christophe Vinsonneau, Cyril Charron, Didier Thévenin, Emmanuel Guérot, Guillaume Besch, Guillaume Savary, Hervé Mentec, Jean-Luc Chagnon, Jean‐Philippe Rigaud, Jean‐Pierre Quenot, Jeremy Castanera, Jérémy Rosman, Julien Maizel, Kelly Tiercelet, Lucie Vettoretti, Maud Mousset Hovaere, Messika Messika, Michel Djibré, Nathalie Rolin, Philippe Burtin, Pierre Garçon, Saad Nseir, Xavier Valette, Christian Rabe, Eberhard Barth, Henning Ebelt, Kristina Fuest, Marcus Franz, Michael Horacek, Michael Schuster, Patrick Meybohm, Sebastian Allgäuer, Simon Dubler, Stefan J. Schaller, Stefan Schering, Stephan Steiner, Thorben Dieck, Tim Rahmel, Tobias Graf, Anastasia Koutsikou, A. Vakalos, Bogdan Raitsiou, Elli Niki Flioni, Evangelia Neou, Fotios Tsimpoukas, Γεώργιος Παπαθανάκος, Giorgos Marinakis, Ioannis Koutsodimitropoulos, Kounougeri Aikaterini, Νikoletta Ρovina, Stylliani Kourelea, Polychronis Tasioudis, V Zidianakis, Vryza Konstantinia, Zoi Aidoni, Catherine Motherway, Chris Read, Ignacio Martín‐Loeches, Andrea Cracchiolo, Aristide Morigi, Italo Calamai, Stefania Brusa, Ahmed Elhadi, Ahmed Tarek, Ala Khaled, Hazem A. Sayed Ahmed, Wesal Ali Belkhair, Alexander D. Cornet, Diederik Gommers, Eva van Boven, Jasper J. Haringman, Lenneke Haas, Lettie van den Berg, Oscar Hoiting, Peter de Jager, Rik Gerritsen, Tom Dormans, Willem Dieperink, Alena Breidablik, Anita Slapgard, Anne-Karin Rime, Bente Jannestad, Britt Sjøbøe, Eva Rice, Hans Frank Strietzel, Jan Peter Jensen, Jørund Langørgen, Kirsti Tøien, Kristian Strand, Michael Hahn, Pål Klepstad, Aleksandra Biernacka, Anna Kluzik, Bartosz Kudliński, Dariusz Maciejewski, Dorota Studzińska, Hubert Hymczak, Jan Stefaniak, Joanna Sołek-Pastuszka, Joanna Zorska, Katarzyna Cwyl, Łukasz J. Krzych, Maciej Żukowski, Małgorzata Lipińska-Gediga, Marek Pietruszko, Mariusz Piechota, Marta Serwa, Mirosław Czuczwar, Mirosław Ziętkiewicz, Natalia Kozera, Paweł Nasiłowski, Paweł Sendur, Paweł Zatorski, Piotr Gałkin, Ryszard Gawda, Urszula Kościuczuk, Waldemar Cyrankiewicz, Wojciech Gola, Alexandre Fernandes Pinto, Ana Margarida Fernandes, Ana Rita Santos, Cristina Sousa, Inês Barros, Isabel Amorim Ferreira, Jacobo Bacariza Blanco, João Teles Carvalho, José Miguel Maia, Nuno R. Candeias, Nuno Catorze, Vladislav Belskiy, Africa Lores, Ángela Prado Mira, Catia Cillóniz, David Pérez-Torres, Emilio Maseda, Enver Rodriguez, Estefanía Prol‐Silva, Gaspar Eixarch, Gemma Gomà, Gerardo Aguilar, Gonzalo Navarro Velasco, Marián Irazábal Jaimes, Mercedes Ibarz Villamayor, Noemí Fernández, Patricia Jimeno Cubero, Sonia López‐Cuenca, Teresa Tomasa, A. SJÖQVIST, Camilla Brorsson, Fredrik Schiöler, Henrik Westberg, Jessica Nauska, Joakim Sivik, Johan Berkius, Karin Kleiven Thiringer, Lina De Geer, Filippo Boroli, Leila Hergafi, P. Eckert, İsmail Yıldız, Ihor Yovenko, Richard Pugh
33Citations signalées, ce qui n’est pas une note de qualité
43Institutions déclarées
17Pays d’affiliation déclarés
Rattachement africain : at, de, se, fr, it, no, es, dk, ie, pt, be, ch, nl, pl, gb, gr, us.
Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Intensive care unit (ICU) patients age 90 years or older represent a growing subgroup and place a huge financial burden on health care resources despite the benefit being unclear. This leads to ethical problems. The present investigation assessed the differences in outcome between nonagenarian and octogenarian ICU patients. METHODS: We included 7900 acutely admitted older critically ill patients from two large, multinational studies. The primary outcome was 30-day-mortality, and the secondary outcome was ICU-mortality. Baseline characteristics consisted of frailty assessed by the Clinical Frailty Scale (CFS), ICU-management, and outcomes were compared between octogenarian (80-89.9 years) and nonagenarian (> 90 years) patients. We used multilevel logistic regression to evaluate differences between octogenarians and nonagenarians. RESULTS: The nonagenarians were 10% of the entire cohort. They experienced a higher percentage of frailty (58% vs 42%; p < 0.001), but lower SOFA scores at admission (6 + 5 vs. 7 + 6; p < 0.001). ICU-management strategies were different. Octogenarians required higher rates of organ support and nonagenarians received higher rates of life-sustaining treatment limitations (40% vs. 33%; p < 0.001). ICU mortality was comparable (27% vs. 27%; p = 0.973) but a higher 30-day-mortality (45% vs. 40%; p = 0.029) was seen in the nonagenarians. After multivariable adjustment nonagenarians had no significantly increased risk for 30-day-mortality (aOR 1.25 (95% CI 0.90-1.74; p = 0.19)). CONCLUSION: After adjustment for confounders, nonagenarians demonstrated no higher 30-day mortality than octogenarian patients. In this study, being age 90 years or more is no particular risk factor for an adverse outcome. This should be considered- together with illness severity and pre-existing functional capacity - to effectively guide triage decisions. TRIAL REGISTRATION: NCT03134807 and NCT03370692 .
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Management and outcomes in critically ill nonagenarian versus octogenarian patients
- Date Crossref
- 19/10/2021
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Les institutions déclarées
Une affiliation ne permet pas de déduire la nationalité d’un auteur.
Les sujets associés
Frailty in Older AdultsCardiac, Anesthesia and Surgical OutcomesHip and Femur Fractures