Department of Pulmonary and Critical Care Medicine, Malatya Training and Research Hospital, Malatya, Turkey
Department of Anesthesiology and Reanimation, Malatya Training and Research Hospital, Malatya, Turkey
Turk J Med Sci. 2021 Dec 13;51(6):2968-2977. doi: 10.3906/sag-2104-359.
BACKGROUND/AIM: Nowadays, with the rise in average life expectancy, the rate of hospitalization of the older population in intensive care unit (ICU) is gradually increasing. Unfortunately, there are no ideal combination of prognostic factors predicting the mortality in older patients admitted to the ICU. In the present study, we aim to determine the prognostic factors and their impacts on short-time mortality in older critically ill patients.
This retrospective cohort study was performed between January 2019 and February 2020. We included 133 patients aged ≥80 years and hospitalized ≥24 h in the ICU.
A total of 133 critically ill patients enrolled in the present study. And, the median age of the patients was 85 (80–106) years. 30-days and overall ICU mortality rates were found 30.1% and 34.6%, respectively. The patients were grouped as survivors (n = 94) and nonsurvivors (n = 39). Hospital length of stay before the ICU admission was found significantly longer in nonsurvivors (p = 0.001). Sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation-II (APACHE-II) score were significantly higher in nonsurvivors (p < 0.001, p < 0.001). Also, blood lactate level and glucose level were respectively significantly higher in nonsurvivors (p < 0.001, p = 0.006). We found that modified nutrition risk in critically ill (mNUTRIC) score and prehospital clinical frailty scale (CFS) were independent prognostic factors for the older critically ill patients (HR = 9.19, 95% CI=1.47–57.32, p = 0.018, HR = 20.16, 95% CI = 2.63–54.07, p =0.004).
mNUTRIC score and prehospital CFS score were the most important prognostic factors in the admission of older patients to intensive care units.
背景/目的：如今，随着平均预期寿命的提高，重症监护病房（ICU）老年患者的住院率逐渐上升。不幸的是，目前还没有理想的综合预后因素来预测 ICU 老年患者的死亡率。本研究旨在确定预测因素及其对老年危重症患者短期死亡率的影响。
本回顾性队列研究于 2019 年 1 月至 2020 年 2 月进行。我们纳入了在 ICU 住院≥24 小时且年龄≥80 岁的 133 例患者。
本研究共纳入 133 例危重症患者，患者中位年龄为 85（80-106）岁。30 天和总体 ICU 死亡率分别为 30.1%和 34.6%。患者分为存活组（n=94）和非存活组（n=39）。非存活组患者 ICU 入院前的住院时间明显更长（p=0.001）。非存活组患者序贯器官衰竭评估（SOFA）评分和急性生理学和慢性健康评估-II（APACHE-II）评分明显更高（p<0.001，p<0.001）。此外，非存活组患者血乳酸水平和血糖水平分别明显更高（p<0.001，p=0.006）。我们发现改良重症患者营养风险指数（mNUTRIC）评分和院前临床虚弱量表（CFS）是老年危重症患者的独立预后因素（HR=9.19，95%CI=1.47-57.32，p=0.018，HR=20.16，95%CI=2.63-54.07，p=0.004）。
mNUTRIC 评分和院前 CFS 评分是老年患者入住 ICU 的最重要预后因素。
