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

Dempsey, Ged, Hungerford, Dan ORCID: 0000-0002-9770-0163, McHale, Phil ORCID: 0000-0002-8560-2291, McGarey, Lauren, Benison, Edward and Morton, Ben ORCID: 0000-0002-6164-2854
(2020) Long term outcomes for elderly patients after emergency intensive care admission: A cohort study. PLoS One, 15 (10). e0241244-e0241244.

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<h4>Background</h4>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.<h4>Aim</h4>To determine factors associated with long-term survival following ICU admission.<h4>Design</h4>A cohort study of patients aged ≥ 80 years of age admitted to the ICU as an emergency.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.

Item Type: Article
Uncontrolled Keywords: Humans, Disease-Free Survival, Critical Care, Patient Admission, Survival Rate, Aged, 80 and over, Intensive Care Units, Emergency Medical Services, Female, Male
Depositing User: Symplectic Admin
Date Deposited: 03 Nov 2020 09:52
Last Modified: 18 Jan 2023 23:23
DOI: 10.1371/journal.pone.0241244
Open Access URL: https://journals.plos.org/plosone/article?id=10.13...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3105934