학술논문
A retrospective cohort study comparing differences in 30-day mortality among critically ill patients aged ≥ 70 years treated in European tax-based healthcare systems (THS) versus social health insurance systems
Document Type
article
Author
Bernhard Wernly; Hans Flaatten; Michael Beil; Jesper Fjølner; Raphael Romano Bruno; Antonio Artigas; Bernardo Bollen Pinto; Joerg C. Schefold; Malte Kelm; Sviri Sigal; Peter Vernon van Heerden; Wojciech Szczeklik; Muhammed Elhadi; Michael Joannidis; Richard Rezar; Sandra Oeyen; Georg Wolff; Brian Marsh; Finn H. Andersen; Rui Moreno; Sarah Wernly; Susannah Leaver; Ariane Boumendil; Dylan W. De Lange; Bertrand Guidet; Stefan Perings; Christian Jung
Source
Scientific Reports, Vol 12, Iss 1, Pp 1-9 (2022)
Subject
Language
English
ISSN
2045-2322
Abstract
Abstract In Europe, tax-based healthcare systems (THS) and social health insurance systems (SHI) coexist. We examined differences in 30-day mortality among critically ill patients aged ≥ 70 years treated in intensive care units in a THS or SHI. Retrospective cohort study. 2406 (THS n = 886; SHI n = 1520) critically ill ≥ 70 years patients in 129 ICUs. Generalized estimation equations with robust standard errors were chosen to create population average adjusted odds ratios (aOR). Data were adjusted for patient-specific variables, organ support and health economic data. The primary outcome was 30-day-mortality. Numerical differences between SHI and THS in SOFA scores (6 ± 3 vs. 5 ± 3; p = 0.002) were observed, but clinical frailty scores were similar (> 4; 17% vs. 14%; p = 0.09). Higher rates of renal replacement therapy (18% vs. 11%; p