University of Health Sciences, Sultan 2. Abdülhamit Han Education and Reseach Hospital, Istanbul, Turkey.
Niger J Clin Pract. 2023 Feb;26(2):145-152. doi: 10.4103/njcp.njcp_1628_21.
Treatment of geriatric intensive care patients is tiring and difficult for intensive care physicians due to comorbidities, accompanying acute illnesses and vulnerabilities.
The aim of our study was to determine other factors affecting mortality and morbidity with age in geriatric intensive care patients.
A total of 937 geriatric intensive care patients were divided into three groups as young-old (65-74 years), middle-old (75-84 years), and oldest-old (85 years and more). Demographic characteristics such as age, gender, and comorbid diseases (oncological malignancy, chronic renal failure, sepsis, chronic anemia, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, pulmonary embolism) were recorded. The number of patients who needed a mechanical ventilator, developed decubit ulcers, underwent percutaneous tracheostomy, and renal replacement therapy were recorded. In addition, the number of central venous catheter insertions for patients, Acute Physiology and Chronic Health Evaluation II scores (APACHE II), hospitalization days, and mortality rates were recorded and compared.
In the comparison between the groups in terms of gender, in the 65-74 years' age group, male gender was higher, while in the age group of 85 years and more, the female gender was found to be statistically higher. Among comorbid diseases, the rate of oncological malignancy was found to be statistically significantly lower in patients aged 85 years and more. Comparing the APACHE II scores of the patients as per the groups, scores were found to be statistically significantly higher in the oldest-old group. APACHE II Score, central venous catheter application, chronic obstructive pulmonary disease, chronic renal failure, sepsis, oncological malignancy, and renal replacement therapy were shown to be statistically significant as factors affecting death. The factors affecting the survival or hospitalization time of the patients of decubit ulcer, mechanical ventilator, percutaneous tracheostomy, chronic obstructive pulmonary disease, Sepsis, APACHE II Score, and age were shown to be statistically significant.
Our study showed that not only age has an effect on mortality and morbidity in geriatric intensive care patients but also comorbidities and intensive care treatments of the patients are also effective in this process.
由于合并症、伴随的急性疾病和脆弱性，老年重症监护患者的治疗对重症监护医生来说既疲惫又困难。
我们的研究旨在确定影响老年重症监护患者死亡率和发病率的其他因素与年龄的关系。
总共纳入 937 名老年重症监护患者，分为三组：年轻老年组（65-74 岁）、中龄老年组（75-84 岁）和高龄老年组（85 岁及以上）。记录了年龄、性别和合并症（恶性肿瘤、慢性肾衰竭、脓毒症、慢性贫血、高血压、糖尿病、慢性阻塞性肺疾病、肺栓塞）等人口统计学特征。记录了需要使用机械呼吸机、发生压疮、接受经皮气管切开术和肾脏替代治疗的患者人数。此外，还记录了患者的中心静脉导管插入次数、急性生理学和慢性健康评估 II 评分（APACHE II）、住院天数和死亡率，并进行了比较。
在组间比较中，在 65-74 岁年龄组中，男性比例较高，而在 85 岁及以上年龄组中，女性比例较高。在合并症方面，85 岁及以上患者的恶性肿瘤发病率明显较低。比较各组患者的 APACHE II 评分，高龄老年组的评分明显较高。APACHE II 评分、中心静脉导管应用、慢性阻塞性肺疾病、慢性肾衰竭、脓毒症、恶性肿瘤和肾脏替代治疗被认为是影响死亡的统计学显著因素。压疮、机械呼吸机、经皮气管切开术、慢性阻塞性肺疾病、脓毒症、APACHE II 评分和年龄等因素对患者的生存或住院时间有影响。
我们的研究表明，年龄不仅对老年重症监护患者的死亡率和发病率有影响，而且患者的合并症和重症监护治疗也对这一过程有影响。
