Prognosis of Old Intensive Care COVID-19 Patients at a Glance: The Senior COVID Study.


Journal

Turkish journal of anaesthesiology and reanimation
ISSN: 2667-677X
Titre abrégé: Turk J Anaesthesiol Reanim
Pays: Turkey
ID NLM: 101680817

Informations de publication

Date de publication:
Jun 2022
Historique:
entrez: 1 7 2022
pubmed: 2 7 2022
medline: 2 7 2022
Statut: ppublish

Résumé

Admission in the intensive care unit of the old patient with coronavirus disease 19 raises an ethical question concerning the scarce resources and their short-term mortality. Patients aged over 60 from 7 different intensive care units admitted between March 1, 2020 and May 6, 2020, with a diagnosis of coronavirus disease 19 were included in the cohort. Twenty variables were collected during the admission, such as age, severity (Simplified Acute Physiology Score [SAPS] II), several data on physiological status before intensive care unit comorbidities, evaluation of autonomy, frailty, and biological variables. The objective was to model the 30-day mortality with relevant variables, compute their odds ratio associated with their 95% CI, and produce a nomogram to easily estimate and communicate the 30-day mortality. The performance of the model was estimated with the area under the receiving operating curve. We included 231 patients, among them 60 (26.0%) patients have died on the 30th day. The relevant variables selected to explain the 30-day mortality were Instrumental Activities of Daily Living (IADL) score (0.82 [0.71-0.94]), age 1.12 (1.07-1.18), SAPS II 1.05 (1.02-1.08), and dementia 6.22 (1.00-38.58). A nomogram was computed to visually represent the final model. Area under the receiving operating curve was at 0.833 (0.776-0.889). Age, autonomy, dementia, and severity at admission were important predictive variables for the 30-day mortality status, and the nomogram could help the physician in the decision-making process and the communication with the family.

Identifiants

pubmed: 35775799
doi: 10.5152/TJAR.2022.21321
pmc: PMC9629196
doi:

Types de publication

Journal Article

Langues

eng

Pagination

S57-S61

Références

N Engl J Med. 2021 Feb 25;384(8):693-704
pubmed: 32678530
Crit Care. 2016 Apr 09;20:97
pubmed: 27059989
Intensive Care Med. 2017 Dec;43(12):1820-1828
pubmed: 28936626
Crit Care Med. 2021 Jan 1;49(1):102-111
pubmed: 33116052
J Int Med Res. 2020 Aug;48(8):300060520948382
pubmed: 32840156
Eur Heart J Acute Cardiovasc Care. 2020 Apr;9(3):248-252
pubmed: 32347745
BMJ Open. 2021 Jul 6;11(7):e044449
pubmed: 34230013
Crit Care Med. 2016 Aug;44(8):1553-602
pubmed: 27428118
Pharmacol Res. 2020 Aug;158:104931
pubmed: 32446978
J Med Ethics. 2020 Oct;46(10):641-645
pubmed: 32571847

Auteurs

Charles-Hervé Vacheron (CH)

Department of Anaesthesiology and Reanimation, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Biometrics and Evolutionary Biology Laboratory, Biostatistics-Health Team, Hospices Civils de Lyon, Villeurbanne, France; Division of Public Health, Department of Biostatistics and Bioinformatics, Lyon, France.

Laurent Bitker (L)

Department of Intensive Medicine and Resuscitation, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France.

Fabrice Thiolliére (F)

Department of Anaesthesiology and Reanimation, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.

Fabien Subtil (F)

Biometrics and Evolutionary Biology Laboratory, Biostatistics-Health Team, Hospices Civils de Lyon, Villeurbanne, France.

Paul Abraham (P)

Department of Anaesthesia and Resuscitation, Édouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University Faculty of Medicine, Lyon, France.

Vincent Collange (V)

Medipole Lyon Villeurbanne Hospital, Villeurbanne, France.

Baptiste Balança (B)

Department of Anaesthesia and Resuscitation, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon, France.

Max Haïne (M)

North West Hospital of Villefranche, France.

Céline Guichon (C)

Inter-University Laboratory of Human Movement Biology, Villeurbanne, France; Department of Anaesthesia and Surgical Resuscitation, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France.

Christophe Leroy (C)

Department of Intensive Care Medicine, Emile Roux Hospital Center, le Puy en Velay, France.

Marie Simon (M)

Department of Anaesthesia and Resuscitation, Édouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.

Amélie Malapert (A)

Plateforme IC-HCL, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.

Mélanie Roche (M)

Plateforme IC-HCL, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.

Jean-Baptiste Pialat (JB)

Claude Bernard University Faculty of Medicine, Lyon, France.

Laurent Jallades (L)

Department of Biological Hematology, Lyon Sud Hospital South Biology and Pathology Center, Pierre-Bénite, France.

Alain Lepape (A)

Department of Intensive Care, Henry Gabrielle Hospital, Hospices Civils de Lyon, Lyon, France; Department of Critical Care, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon, France.

Arnaud Friggeri (A)

Department of Anaesthesiology and Reanimation, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.

Claire Falandry (C)

Division of Geriatrics, Center Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.

Classifications MeSH