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

• DOI: 10.1371/journal.pone.0241244
• Publication Date: 2020-10-29T18:00:31Z
• Authors: Ged Dempsey; Dan Hungerford; Phil McHale; Lauren McGarey; Edward Benison; Ben Morton
• Keywords: Male; Retrospective cohort study; Emergency Medical Services; Critical Care; Science; Hazard ratio; Population; wt_116; Proportional hazards model; Critical Care and Intensive Care Medicine; Pediatrics; Disease-Free Survival; 03 medical and health sciences; Patient Admission; 0302 clinical medicine; Health Sciences; Humans; Management of Delirium in Critical Care Patients; Internal medicine; Aged, 80 and over; Psychiatry; Emergency department; Management of Cardiac Arrest and Resuscitation; Q; Confidence interval; R; Cohort; Elderly Patients; Survival analysis; wt_100; 3. Good health; Survival Rate; Intensive Care Units; Emergency Department Crowding; Environmental health; wx_200; Survival Rates; Emergency Medicine; Medicine; Emergency medicine; Female; Cohort study; Research Article

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