학술논문
The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years
Document Type
article
Author
Dylan W. de Lange; Ivo W. Soliman; Susannah Leaver; Ariane Boumendil; Lenneke E. M. Haas; Ximena Watson; Carol Boulanger; Wojciech Szczeklik; Antonio Artigas; Alessandro Morandi; Finn Andersen; Christian Jung; Rui Moreno; Sten Walther; Sandra Oeyen; Joerg C. Schefold; Maurizio Cecconi; Brian Marsh; Michael Joannidis; Yuriy Nalapko; Muhammed Elhadi; Jesper Fjølner; Bertrand Guidet; Hans Flaatten; the VIP2 study group
Source
Annals of Intensive Care, Vol 14, Iss 1, Pp 1-9 (2024)
Subject
Language
English
ISSN
2110-5820
Abstract
Abstract Background Premorbid conditions influence the outcome of acutely ill adult patients aged 80 years and over who are admitted to the ICU. The aim of this study was to determine the influence of such premorbid conditions on 6 month survival. Methods Prospective cohort study in 242 ICUs from 22 countries including patients 80 years or above, admitted over a 6 months period to an ICU between May 2018 and May 2019. Only emergency (acute) ICU admissions in adult patients ≥ 80 years of age were eligible. Patients who were admitted after planned/elective surgery were excluded. We measured the Clinical Frailty Scale (CFS), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), disability with the Katz activities of daily living (ADL) score, comorbidities and a Polypharmacy Score (CPS). Results Overall, the VIP2 study included 3920 patients. During ICU stay 1191 patients died (30.9%), and another 436 patients (11.1%) died after ICU discharge but within the first 30 days of admission, and an additional 895 patients died hereafter but within the first 6 months after admission (22.8%). The 6 months mortality was 64%. The median CFS was 4 (IQR 3–6). Frailty (CFS ≥ 5) was present in 26.6%. Cognitive decline (IQCODE above 3.5) was found in 30.2%. The median IQCODE was 3.19. A Katz ADL of 4 or less was present in 27.7%. Patients who surviving > 6 months were slightly younger (median age survivors 84 with IQR 81–86) than patients dying within the first 6 months (median age 84, IQR 82–87, p = 0.013), were less frequently frail (CFS > 5 in 19% versus 34%, p