Association of Age With Short-term and Long-term Mortality Among Patients Discharged From Intensive Care Units in France

Atramont, A.; Lindecker-Cournil, Valérie; Rudant, Jérémie; Tajahmady, Ayden; Drewniak, Nicolas; Fouard, Annie; Singer, Mervyn; Léone, Marc; Legrand, Matthieu

doi:10.1001/jamanetworkopen.2019.3215

Cited by 66 publications

(67 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The association of mortality in COVID‐19 with burden of comorbidity and degree of organ support is a consistent finding 14,15 . The increasing risk of death by increasing age may be more pronounced in COVID‐19 patients than in the general ICU‐population, 18,19 but is likely similar in those with high severity of disease.…”

Section: Discussionmentioning

confidence: 63%

Characteristics, interventions, and longer term outcomes of COVID‐19 ICU patients in Denmark—A nationwide, observational study

Haase

Plovsing

Christensen

et al. 2020

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Background Most data on intensive care unit (ICU) patients with COVID‐19 originate in selected populations from stressed healthcare systems with shorter term follow‐up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID‐19 in Denmark where the ICU capacity was not exceeded. Methods We identified all patients with SARS‐CoV‐2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis. Results There were 323 ICU patients with confirmed COVID‐19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6‐22) and hospital stay 19 days (11‐30). Median follow‐up was 79 days. At end of follow‐up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co‐morbidities. Conclusions In this nationwide, population‐based cohort of ICU patients with COVID‐19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co‐morbidities, in particular chronic pulmonary disease, were associated with increased risk of death.

show abstract

Section: Discussionmentioning

confidence: 63%

Characteristics, interventions, and longer term outcomes of COVID‐19 ICU patients in Denmark—A nationwide, observational study

Haase

Plovsing

Christensen

et al. 2020

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…Most authors have outlined the importance of acute physiological derangement to predict early mortality of elderly ICU patients [ 13 , 26 , 27 , 31 , 32 ]. The role of acute physiology beyond one year is less clear, with some reports of on-going effect of illness severity [ 26 , 31 , 32 ], some suggesting a limited effect [ 29 ] and others that functional status [ 30 ] and frailty [ 28 , 33 ] are more important for long time frames.…”

Section: Discussionmentioning

confidence: 99%

Long term outcomes for elderly patients after emergency intensive care admission: A cohort study

et al. 2020

View full text Add to dashboard Cite

Background Elderly patients (≥ 80 years of age) surviving an episode of critical illness suffer long-term morbidity and risk of mortality. Identifying high risk groups could assist in informing discussions with patients and families. Aim To determine factors associated with long-term survival following ICU admission. Design A cohort study of patients aged ≥ 80 years of age admitted to the ICU as an emergency. Methods Patients admitted from January 2010 to December 2018 were included in the study. Primary outcome was five year survival. Mortality was assessed using a multivariable flexible parametric survival analysis adjusted for demographics, and clinically relevant covariates. Results There were 828 patients. Mean age was 84 years (SD 3.2) and 419 (51%) were male. Patients were categorised into medical (423 (51%)) and surgical (405 (49%)) admissions. Adjusted hazard ratios (aHR) for mortality were highest for serum lactate (>8 mmol/l aHR 2.56 (C.I. 1.79–3.67)), lowest systolic blood pressure (< 70 mmHg aHR 2.04 (C.I. 1.36–3.05)) and pH (< 7.05 aHR 4.70 (C.I 2.67–8.21)). There were no survivors beyond one year with severe abnormalities of pH and lactate (< 7.05 and > 8 mmol/l respectively). Relative survival for medical patients was below that expected for the general population for the duration of the study. Conclusion Overall five-year survival was 27%. For medical and surgical patients it was 19% and 35% respectively. Survival at 30 days and one year was 61% and 46%. The presence of features of circulatory shock predicted poor short and long term survival.

show abstract

“…To a lesser degree, age was a factor associated with mortality in our study. After an ICU admission, aging is associated with an increased risk of mortality in the 3 years after hospital discharge (43).…”

Section: Discussionmentioning

confidence: 99%

Factors predicting short-term and long-term mortality in ICU patients with a malignancy: the importance of SOFA and ECOG performance status

Zee¹,

Noordhuis²,

Epker³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Intensive Care Unit (ICU) triage decisions in patients with a malignancy can be difficult as clinicians have concerns about potential unfavourable outcomes. Therefore, clinicians may have doubts about the appropriateness of an ICU admission. The aim of this study was to assess the long-term mortality and performance status of critically ill patients with an active malignancy or a malignancy in their prior history admitted unplanned to the ICU. Furthermore, we aimed to compare the long-term mortality of those patients to the mortality of patients without a malignancy. Methods We conducted a retrospective cohort study in a large tertiary referral university hospital in the Netherlands. We categorized all adult patients with an unplanned admission to the ICU in 2017 in two groups: 1) the study population consisting of patients with an active malignancy and patients with a malignancy in their medical history (complete remission, CR) and 2) patients without a malignancy. Pearson’s Chi-square tests and Independent Samples T-Tests or the Mann-Whitney U tests were used to evaluate the long-term mortality, the primary objective was 2-year mortality. Results Of the 1046 unplanned ICU admissions, 125 (12%) patients had an active malignancy, 41 (3.9%) < 5 year CR and 33 (3.2%) ≥ 5 year CR. The 2-year mortality in the study population was significantly higher than in the population without a malignancy (67.4% and 40.2%, P < 0.001). The median performance status at 2 years after ICU admission in the study population was 1 (IQR 0–2). SOFA score (OR 1.25; 95% CI 1.10–1.42) and ECOG performance status of 2 (OR 11.23; 95% CI 2.66–47.33), 3 (OR 5.91; 95% CI 1.77–19.79) and 4 (OR 13.16; 1.85–93.74) were independently associated with 2-year mortality. Conclusions Two thirds of the study population died within 2 years after ICU admission, which is higher than in the population without a malignancy. However, the majority of the study population had a good performance status at 2 years after ICU admission. The severity of the critical illness and the performance status before ICU admission are independently associated with 2-year mortality and should be considered as main factors in ICU triage.

show abstract

Association of Age With Short-term and Long-term Mortality Among Patients Discharged From Intensive Care Units in France

Cited by 66 publications

References 20 publications

Characteristics, interventions, and longer term outcomes of COVID‐19 ICU patients in Denmark—A nationwide, observational study

Characteristics, interventions, and longer term outcomes of COVID‐19 ICU patients in Denmark—A nationwide, observational study

Long term outcomes for elderly patients after emergency intensive care admission: A cohort study

Factors predicting short-term and long-term mortality in ICU patients with a malignancy: the importance of SOFA and ECOG performance status

Contact Info

Product

Resources

About