Prognostic nomogram for elderly patients with acute respiratory failure receiving invasive mechanical ventilation: a nationwide population-based cohort study in Taiwan.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
04 08 2020
04 08 2020
Historique:
received:
12
09
2019
accepted:
21
05
2020
entrez:
6
8
2020
pubmed:
6
8
2020
medline:
15
12
2020
Statut:
epublish
Résumé
Patients in critical care medicine are ageing. There is limited literature evaluating long-term outcomes and prognostic factors for the growing number of elderly patients with acute respiratory failure (ARF) receiving invasive mechanical ventilation (IMV). Data on elderly patients (≧ 65 years old) with ARF receiving intubation and IMV during 2003-2012 were retrospectively collected from the national health database in Taiwan. We included 7,095 elderly patients. The 28-day mortality was 33%, the 60-day mortality was 47.5%, and the 1-year mortality was 70.4%. Patients were divided into groups: young-old (65-74 years), middle-old (75-84 years), and oldest-old (≧ 85 years). Patients in the oldest-old and middle-old groups had higher 1-year mortality than the young-old group (p < 0.001). The multivariate logistic regression revealed 9 significant factors associated with 1-year mortality, and these factors were used to develop a prognostic nomogram. The present study showed that the long-term prognosis of elderly patients with ARF and IMV is very poor. This nomogram can help physicians estimate the 1-year mortality of elderly patients in the early stage of ARF and assist in clinical decision making.
Identifiants
pubmed: 32753615
doi: 10.1038/s41598-020-70130-x
pii: 10.1038/s41598-020-70130-x
pmc: PMC7403322
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
13161Références
World Health Organization, World report on ageing and health 2015. https://www.who.int/ageing/events/world-report-2015-launch/en/ (access on 2019/8/9).
United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2013. 6–13 (United Nations, 2013).
Lin, Y. Y. & Huang, C. S. Aging in Taiwan: building a society for active aging and aging in place. Gerontologist. 56, 176–183 (2016).
doi: 10.1093/geront/gnv107
Flaatten, H. et al. The status of intensive care medicine research and a future agenda for very old patients in the ICU. Intensive Care Med. 43, 1319–1328 (2017).
doi: 10.1007/s00134-017-4718-z
Ferrante, L. E. et al. Functional trajectories among older persons before and after critical illness. JAMA Intern. Med. 175, 523–529 (2015).
doi: 10.1001/jamainternmed.2014.7889
Chung, Y. C. et al. An outcome analysis of mechanically ventilated middle aged and elderly Taiwanese patients undergoing tracheostomy. Int. J. Gerontol. 7, 70–74 (2013).
doi: 10.1016/j.ijge.2012.07.006
Lieberman, D. et al. Elderly patients undergoing mechanical ventilation in and out of intensive care units: a comparative, prospective study of 579 ventilations. Crit. Care 14, R48 (2010).
doi: 10.1186/cc8935
Barnato, A. E., Albert, S. M., Angus, D. C., Lave, J. R. & Degenholtz, H. B. Disability among elderly survivors of mechanical ventilation. Am. J. Respir. Crit. Care Med. 183, 1037–1142 (2011).
doi: 10.1164/rccm.201002-0301OC
National Health Insurance Administration, Ministry of Health and Welfare, Taiwan, R.O.C. National Health Insurance Annual Report 2014–2015. (Wu Nan, 2014).
Zizza, C. A., Ellison, K. J. & Wernette, C. M. Total water intakes of community-living middle-old and oldest-old adults. J. Gerontol. A. Biol. Sci. Med. Sci. 64, 481–486 (2009).
doi: 10.1093/gerona/gln045
Halter, J. B. et al. Hazzard’s Geriatric Medicine and Gerontology 6th edn, 871 (McGraw-Hill, New York, 2009).
Charlson, M. E., Pompei, P., Ales, K. L. & MacKenzie, C. R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J. Chronic Dis. 40, 373–383 (1987).
doi: 10.1016/0021-9681(87)90171-8
Zlotnik, A. & Abraira, V. A general-purpose nomogram generator for predictive logistic regression models. Stata J. 15, 537–546 (2015).
doi: 10.1177/1536867X1501500212
Esteban, A. et al. Evolution of mortality over time in patients receiving mechanical ventilation. Am. J. Respir. Crit. Care Med. 188, 220–230 (2013).
doi: 10.1164/rccm.201212-2169OC
Chen, C. J., Shi, H. Y., Lee, K. T. & Huang, T. Y. In-hospital mortality prediction in patients receiving mechanical ventilation in Taiwan. Am. J. Crit. Care 22, 506–513 (2013).
doi: 10.4037/ajcc2013950
Wang, C. H. et al. Predictive factors of in-hospital mortality in ventilated intensive care unit. Medicine (Baltimore) 96, e9165 (2017).
doi: 10.1097/MD.0000000000009165
Stauffer, J. L. et al. Survival following mechanical ventilation for acute respiratory failure in adult men. Chest 104, 1222–1229 (1993).
doi: 10.1378/chest.104.4.1222
Foerch, C., Kessler, K. R., Steckel, D. A., Steinmetz, H. & Sitzer, M. Survival and quality of life outcome after mechanical ventilation in elderly stroke patients. J. Neurol. Neurosurg. Psychiatry 75, 988–993 (2004).
doi: 10.1136/jnnp.2003.021014
Hajizadeh, N., Goldfeld, K. & Crothers, K. What happens to patients with COPD with long-term oxygen treatment who receive mechanical ventilation for COPD exacerbation? A 1-year retrospective follow-up study. Thorax 70, 294–296 (2015).
doi: 10.1136/thoraxjnl-2014-205248
Leblanc, G., Boumendil, A. & Guidet, B. T. things to know about critically ill elderly patients. Intensive Care Med. 43, 217–219 (2017).
doi: 10.1007/s00134-016-4477-2
Lin, Y. C. et al. Outcome of lung cancer patients with acute respiratory failure requiring mechanical ventilation. Respir. Med. 98, 43–51 (2004).
doi: 10.1016/j.rmed.2003.07.009
Saillard, C., Mokart, D., Lemiale, V. & Azoulay, E. Mechanical ventilation in cancer patients. Minerva Anestesiol. 80, 712–725 (2014).
pubmed: 24280820
Huaringa, A. J. & Francis, W. H. Outcome of invasive mechanical ventilation in cancer patients: Intubate or not to intubate a patient with cancer. J. Crit. Care 50, 87–91 (2019).
doi: 10.1016/j.jcrc.2018.11.014
Esteban, A. et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA 287, 345–355 (2002).
doi: 10.1001/jama.287.3.345
Sprung, C. L. et al. The Eldicus prospective, observational study of triage decision making in European intensive care units. Part II: intensive care benefit for the elderly. Crit. Care Med. 40, 132–138 (2012).
doi: 10.1097/CCM.0b013e318232d6b0
Shen, H. N., Lu, C. L. & Yang, H. H. Women receive more trials of noninvasive ventilation for acute respiratory failure than men: a nationwide population-based study. Crit. Care 15, R174 (2011).
doi: 10.1186/cc10323
Lin, P. H. et al. Outcomes of unplanned extubation in ordinary ward are similar to those in intensive care unit: a STROBE-compliant case-control study. Medicine (Baltimore) 98, e14841 (2019).
doi: 10.1097/MD.0000000000014841
Hui, D. et al. Concepts and definitions for “actively dying,” “end of life,” “terminally ill,” “terminal care,” and “transition of care”: a systematic review. J. Pain Symptom Manag. 47, 77–89 (2014).
doi: 10.1016/j.jpainsymman.2013.02.021
Balachandran, V. P., Gonen, M., Smith, J. J. & DeMatteo, R. P. Nomograms in oncology: more than meets the eye. Lancet Oncol. 16, e173-180 (2015).
doi: 10.1016/S1470-2045(14)71116-7
Liang, W. et al. Development and validation of a nomogram for predicting survival in patients with resected non-small-cell lung cancer. J. Clin. Oncol. 33, 861–869 (2015).
doi: 10.1200/JCO.2014.56.6661
Deng, X. et al. Development of a nomogram for identification of asthma among adults in epidemiologic studies. Ann. Allergy Asthma Immunol. 105, 203–210 (2010).
doi: 10.1016/j.anai.2010.06.020
Hasegawa, W. et al. Prognostic nomogram for inpatients with asthma exacerbation. BMC Pulm. Med. 17, 108 (2017).
doi: 10.1186/s12890-017-0450-2
Lai, C. C. et al. Establishing predictors for successfully planned endotracheal extubation. Medicine (Baltimore) 95, e4852 (2016).
doi: 10.1097/MD.0000000000004852
Xie, D. et al. Nomograms predict overall survival for patients with small-cell lung cancer incorporating pretreatment peripheral blood markers. J. Thorac. Oncol. 10, 1213–1220 (2015).
doi: 10.1097/JTO.0000000000000585
Brummel, N. E. et al. Frailty and subsequent disability and mortality among patients with critical illness. Am. J. Respir. Crit. Care Med. 196, 64–72 (2017).
doi: 10.1164/rccm.201605-0939OC
Muscedere, J. et al. The impact of frailty on intensive care unit outcomes: a systematic review and meta-analysis. Intensive Care Med. 43, 1105–1122 (2017).
doi: 10.1007/s00134-017-4867-0
Ministry of Health and Welfare of Taiwan, Hospital and Clinic statistics, 2011, Table 35 Number of Hospitals, Clinics and Beds in Each Medical Care Region. https://www.mohw.gov.tw/dl-31446-c9ccdf87-4aaf-40ee-87fc-bb580bab4a2f.html (2011)
Wallace, D. J., Angus, D. C., Seymour, C. W., Barnato, A. E. & Kahn, J. M. Critical care bed growth in the United States: A comparison of regional and national trends. Am. J. Respir. Crit. Care Med. 191, 410–416 (2015).
doi: 10.1164/rccm.201409-1746OC
Rhodes, A. et al. The variability of critical care bed numbers in Europe. Intensive Care Med. 38, 1647–1653 (2012).
doi: 10.1007/s00134-012-2627-8