Propensity-Adjusted Comparison of Mortality of Elderly Versus Very Elderly Ventilated Patients.


Journal

Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357

Informations de publication

Date de publication:
May 2021
Historique:
pubmed: 4 3 2021
medline: 20 5 2021
entrez: 3 3 2021
Statut: ppublish

Résumé

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. 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; Very elderly subjects were clinically sicker as expressed by higher SAPS II scores (53 ± 18 vs 50 ± 18, 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.).

Sections du résumé

BACKGROUND 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 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;
RESULTS RESULTS
Very elderly subjects were clinically sicker as expressed by higher SAPS II scores (53 ± 18 vs 50 ± 18,
CONCLUSIONS 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.).

Identifiants

pubmed: 33653910
pii: respcare.08547
doi: 10.4187/respcare.08547
doi:

Banques de données

ClinicalTrials.gov
['NCT02731898']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

814-821

Informations de copyright

Copyright © 2021 by Daedalus Enterprises.

Déclaration de conflit d'intérêts

The authors have disclosed no conflicts of interest.

Auteurs

Bernhard Wernly (B)

Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.

Raphael Romano Bruno (RR)

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.

Fernando Frutos-Vivar (F)

Hospital Universitario de Getafe & Centro de Investigación en Red de Enfermedades Respiratorias, Getafe, Spain.

Oscar Peñuelas (O)

Medizinische Hochschule, Hannover, Germany.

Richard Rezar (R)

Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, Salzburg, Austria.

Konstantinos Raymondos (K)

Medizinische Hochschule, Hannover, Germany.

Alfonso Muriel (A)

Hospital Universitario de Getafe & Centro de Investigación en Red de Enfermedades Respiratorias, Getafe, Spain.
Unidad de Bioestadística, Clinica Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigaciones Sanitarias & Centro de Investigación en Red de Opidemiología y Salud Pública, Madrid, Spain.

Bin Du (B)

Peking Union Medical College Hospital, Beijing, People's Republic of China.

Arnaud W Thille (AW)

University Hospital of Poitiers, Poitiers, France.

Fernando Ríos (F)

Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina.

Marco González (M)

Clínica Medellín & Universidad Pontificia Bolivariana, Medellín, Colombia.

Lorenzo Del-Sorbo (L)

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.

Maria Del Carmen Marín (MDC)

Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Hospital Regional 1 de Octubre, México City, México.

Bruno Valle Pinheiro (BV)

Pulmonary Research Laboratory, Federal University of Juiz de Fora, Juiz de Fora, Brazil.

Marco Antonio Soares (MA)

Hospital Universitario Sao Jose, Belo Horizonte, Brazil.

Nicolas Nin (N)

Hospital Universitario de Montevideo, Montevideo, Uruguay.

Salvatore M Maggiore (SM)

Università degli Studi G. d'Annunzio Chieti e Pescara, Chieti, Italy.

Andrew Bersten (A)

Department of Critical Care Medicine, Flinders University, Adelaide, South Australia, Australia.

Malte Kelm (M)

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.

Pravin Amin (P)

Bombay Hospital Institute of Medical Sciences, Mumbai, India.

Nahit Cakar (N)

Istanbul Faculty of Medicine, Istanbul, Turkey.

Gee Young Suh (G)

Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea.

Fekri Abroug (F)

Hospital Fattouma Bourguina, Monastir, Tunisia.

Manuel Jibaja (M)

Hospital de Especialidades Eugenio Espejo, Quito, Ecuador.

Dimitros Matamis (D)

Papageorgiou Hospital, Thessaloniki, Greece.

Amine Ali Zeggwagh (AA)

Centre Hospitalier Universitarie, Ibn Sina - Mohammed V University, Rabat, Morocco.

Yuda Sutherasan (Y)

Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Bertrand Guidet (B)

Hôpitaux de Paris, Hôpital Saint-Antoine, service de réanimation médicale, Sorbonne Universités, Paris, France.

Dylan W De Lange (DW)

Department of Intensive Care Medicine, University Medical Center, University Utrecht, Utrecht, The Netherlands.

Michael Beil (M)

Medical Intensive Care Unit, Hadassah University Hospital, Jerusalem, Israel.

Sigal Svri (S)

Medical Intensive Care Unit, Hadassah University Hospital, Jerusalem, Israel.

Vernon van Heerden (V)

Medical Intensive Care Unit, Hadassah University Hospital, Jerusalem, Israel.

Hans Flaatten (H)

Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway.

Antonio Anzueto (A)

South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas.

Venet Osmani (V)

Fondazione Bruno Kessler Research Institute, Trento, Italy.

Andrés Esteban (A)

Hospital Universitario de Getafe & Centro de Investigación en Red de Enfermedades Respiratorias, Getafe, Spain.

Christian Jung (C)

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany. christian.jung@med.uni-duesseldorf.de.

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