Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality
|dc.identifier.citation||Frost, Steven A. and Davidson, Patricia M. and Alexandrou, Evan and Hunt, Leanne and Salamonson, Yenna and Tam, Victor and Parr, Michael J.A. and Aneman, Anders and Hillman, Ken M. 2010. Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality. Critical Care and Resuscitation. 12 (3): pp. 171-176.|
Background: Unplanned admission to the intensive care unit has been shown to significantly increase the risk of in-hospital mortality. Medical advances and increased expectations have resulted in a greater number of very elderly patients (80 years and over) being admitted to the ICU. The risk of in-hospital death associated with unplanned admission to the ICU in very elderly patients has not been clearly defined. Objective: To estimate the risk of in-hospital mortality associated with unplanned admission to the ICU in patients aged 80 years and over. Design, setting and participants: Retrospective review of an adult intensive care database. The setting was Liverpool Hospital, a large teaching hospital in Sydney, Australia, witha 28-bed ICU that has about 2000 admissions per year. We analysed data on very elderly patients (n = 1680), aged 80years or more, admitted to the ICU between 1 January 1997 and 31 December 2007.Main outcome measures: Baseline risk factors for in-hospital mortality. Results: Mortality among patients with unplanned ICU admissions was 47%, compared with 25% in patients with planned admissions (adjusted rate ratio [RR], 1.92 [95% CI,1.59-2.32]). An estimated 50% of the overall risk of in-hospital death among very elderly patients was attributable to a combination of unplanned admission to the ICU, the presence of at least one comorbid condition, acute renal failure and respiratory failure requiring intubation. Conclusion: Unplanned admission to the ICU increases the risk of in-hospital mortality in very elderly patients. At least 50% of the risk of in-hospital death in this age group is attributable to a combination of unplanned ICU admission, comorbidity (1 comorbid condition), acute renal failure and respiratory failure.
|dc.publisher||College of Intensive Care Medicine|
|dc.title||Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality|
|dcterms.source.title||Critical Care and Resuscitation|
Published by the College of Intensive Care Medicine of Australia and New Zealand.
|curtin.department||Centre for Cardiovascular and Chronic Care|