Migeon Adrien, Kassa-Sombo Arthur, Laurent Emeline, Godillon Lucile, Grammatico-Guillon Leslie, Guillon Antoine
Department of Geriatrics, Tours University Hospital, Tours, France.
Epidemiology Unit EpiDcliC, Clinical Data Center, Service of Public Health, Tours University Hospital, Tours, France.
Ann Intensive Care. 2025 May 27;15(1):73. doi: 10.1186/s13613-025-01485-5.
As the trajectory of very old critically-ill patients becomes an increasingly significant global challenge, these patients are often referred to intermediate care units. Intermediate care units provide a level of care that is less intensive than the intensive care unit (ICU) but more advanced than standard hospital wards. We aimed to assess the nationwide utilization of intermediate care units for critically ill patients aged 80 years or older (≥ 80 y.o.) and to examine their characteristics and long-term mortality outcomes.
From the overall adult population (aged 18 years and older) hospitalized in France (French Hospital Discharge Database) from January 1, 2014, to December 31, 2022, patients ≥ 80 y.o. were included. We examined trends in the utilization of medical intermediate care units for critically ill patients ≥ 80 y.o and reported patient characteristics, including the Charlson comorbidity index and Hospital Frailty Risk Score. Readmission rates (hospital or rehabilitation unit) and mortality rates were calculated during a one-year follow-up period after the end of hospital stay.
The proportion of patients ≥ 80 y.o. in intermediate care units was 31% whereas it was 17% in ICU. Patients with greater comorbidities and severity were more frequently hospitalized in polyvalent intermediate care units (10% of them receiving acute organ support) compared to specialized intermediate care units. Admission to intermediate care units was associated with a 14% mortality rate during the stay, 28% at one year. Additionally, 58% of intermediate care units patients were rehospitalized within the year following discharge (6% in critical care units).
One-third of the patients hospitalized in the intermediate care units in France are aged 80 years or older.
随着高龄重症患者的救治成为日益严峻的全球性挑战，这些患者常被转诊至中级护理病房。中级护理病房提供的护理强度低于重症监护病房（ICU），但比标准医院病房更高级。我们旨在评估法国全国范围内80岁及以上（≥80岁）重症患者对中级护理病房的使用情况，并研究其特征和长期死亡率结局。
纳入2014年1月1日至2022年12月31日在法国住院的全体成年人口（18岁及以上）（法国医院出院数据库）中年龄≥80岁的患者。我们研究了80岁及以上重症患者对医疗中级护理病房的使用趋势，并报告了患者特征，包括查尔森合并症指数和医院衰弱风险评分。在住院结束后的一年随访期内计算再入院率（医院或康复病房）和死亡率。
中级护理病房中80岁及以上患者的比例为31%，而ICU中这一比例为17%。与专科中级护理病房相比，合并症更多、病情更严重的患者更频繁地入住多学科中级护理病房（其中10%接受急性器官支持）。入住中级护理病房的患者住院期间死亡率为14%，一年时为28%。此外，58%的中级护理病房患者在出院后一年内再次住院（重症监护病房为6%）。
法国中级护理病房中三分之一的住院患者年龄在80岁及以上。
