Alves Gisele Collyer, Silva Júnior Geraldo Bezerra da, Lima Rafael Siqueira Athayde, Sobral Juliana Barbosa, Mota Rosa Maria Salani, Abreu Krasnalhia Lívia Soares de, Rocha Natália Albuquerque, Nogueira Charlys Barbosa, Daher Elizabeth De Francesco
Escola de Saúde Pública do Ceará, Fortaleza, CE, Brasil.
Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
Rev Bras Ter Intensiva. 2010 Jun;22(2):138-43.
The elderly population is increasing all over the world. The need of intensive care by the elderly is also increasing. There is a lack of studies investigating the risk factors for death among critically ill elderly patients. This study aims to investigate the factors associated with death in a population of critically ill elderly patients admitted to an intensive care unit in Brazil.
This is a retrospective cohort study including all elderly patients (>60 years) admitted to an intensive care unit in Fortaleza, Brazil, from January to December 2007. A comparison between survivors and nonsurvivors was done and the risk factors for death were investigated through univariate and multivariate analysis.
A total of 84 patients were included, with an average age of 73 ± 7.6 years; 59% were female. Mortality was 62.8%. The main cause of death was multiple organ dysfunction (42.3%), followed by septic shock (36.5%) and cardiogenic shock (9.7%). Complications during intensive care unit ICU stay associated with death were respiratory failure (OR=61, p<0.001), acute kidney injury (OR=23, p<0.001), sepsis (OR=12, p<0.001), metabolic acidosis (OR=17, p<0.001), anemia (OR=8.6, p<0.005), coagulation disturbance (OR=5.9, p<0.001) and atrial fibrillation (OR=4.8, p<0.041). Independent risk factors for death were age (OR=1.15, p<0.005), coma (OR=7.51, p<0.003), hypotension (OR=21.75, p=0.003), respiratory failure (OR=9.93, p<0.0001) and acute kidney injury (OR=16.28, p<0.014).
Mortality is high among critically ill elderly patients. Factors associated with death were age, coma, hypotension, respiratory failure and acute kidney injury.
全球老年人口正在增加。老年人对重症监护的需求也在增加。目前缺乏对危重症老年患者死亡危险因素的研究。本研究旨在调查巴西一家重症监护病房收治的危重症老年患者群体中与死亡相关的因素。
这是一项回顾性队列研究，纳入了2007年1月至12月期间入住巴西福塔雷萨一家重症监护病房的所有老年患者（>60岁）。对幸存者和非幸存者进行了比较，并通过单因素和多因素分析调查了死亡危险因素。
共纳入84例患者，平均年龄73±7.6岁；59%为女性。死亡率为62.8%。主要死亡原因是多器官功能障碍（42.3%），其次是感染性休克（36.5%）和心源性休克（9.7%）。重症监护病房（ICU）住院期间与死亡相关的并发症有呼吸衰竭（OR=61，p<0.001）、急性肾损伤（OR=23，p<0.001）、脓毒症（OR=12，p<0.001）、代谢性酸中毒（OR=17，p<0.001）、贫血（OR=8.6，p<0.005）、凝血障碍（OR=5.9，p<0.001）和心房颤动（OR=4.8，p<0.041）。死亡的独立危险因素有年龄（OR=1.15，p<0.005）、昏迷（OR=7.51，p<0.003）、低血压（OR=21.75，p=0.）、呼吸衰竭（OR=9.93，p<0.0001）和急性肾损伤（OR=16.28，p<0.014）。
危重症老年患者死亡率较高。与死亡相关因素有年龄、昏迷、低血压、呼吸衰竭和急性肾损伤。
