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A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention

VIP1 Study Grp, Jung, C., Wernly, B., Muessig, J. M., Kelm, M., Boumendil, A., Morandi, A., Andersen, F. H., Artigas, A., Bertolini, G., Cecconi, M., Christensen, S., Faraldi, L., Fjolner, J., Lichtenauer, M., Bruno, R. R., Marsh, B., Moreno, R., Oeyen, S., Ohman, C. A., Pinto, B. B., Soliman, I. W., Szczeklik, W., Valentin, A., Watson, X., Zafeiridis, T., De Lange, D. W., Guidet, B. & Flaatten, H., Aug-2019, In : Journal of Critical Care. 52, p. 141-148 8 p.

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  • A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention

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DOI

  • VIP1 Study Grp
  • Christian Jung
  • Bernhard Wernly
  • Johanna M. Muessig
  • Malte Kelm
  • Ariane Boumendil
  • Alessandro Morandi
  • Finn H. Andersen
  • Antonio Artigas
  • Guido Bertolini
  • Maurizio Cecconi
  • Steffen Christensen
  • Loredana Faraldi
  • Jesper Fjolner
  • Michael Lichtenauer
  • Raphael Romano Bruno
  • Brian Marsh
  • Rui Moreno
  • Sandra Oeyen
  • Christina Agvald Ohman
  • Bernadro Bollen Pinto
  • Ivo W. Soliman
  • Wojciech Szczeklik
  • Andreas Valentin
  • Ximena Watson
  • Tilemachos Zafeiridis
  • Dylan W. De Lange
  • Bertrand Guidet
  • Hans Flaatten

Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.

Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.

Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p <0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p <0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).

Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery. (C) 2019 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)141-148
Number of pages8
JournalJournal of Critical Care
Volume52
Publication statusPublished - Aug-2019

    Keywords

  • Critically ill, Frailty, Elective, Outcome, Older, Old, QUALITY-OF-LIFE, ELDERLY-PATIENTS, CRITICAL ILLNESS, FRAILTY, MORTALITY, SCORE, PREDICTION, OUTCOMES, ICU

ID: 88337228