Long-term survival of elderly patients after intensive care unit admission for acute respiratory infection: a population-based, propensity-score matched cohort study.
Background Intensive care unit (ICU) hospitalisations of elderly patients with acute respiratory infection have increased, yet the long-term effects of ICU admission among elderly individuals remain unknown. We examined differences over the two years after discharge in mortality, healthcare utilization and frailty score between elderly survivors of ARI in the ICU and an elderly control population.
Methods We used 2009-2017 data from 39 hospital discharge databases. Patients ≥80 years old discharged alive from ICU-hospitalisation for acute respiratory infection were propensity-score matched with controls (cataract surgery) discharged from the hospital at the same time and adjusted for age, sex and comorbidities present before hospitalisation. We reported 2-year mortality and compared healthcare utilization and frailty scores in the 2-year periods before and after ICU-hospitalisation.
Results 1,220 elderly survivors of acute respiratory infection in the ICU were discharged, and 988 were successfully matched with controls. After discharge, patients had a 10.1-fold [95%CI, 6.1-17.3] higher risk of death at 6 months and 3.6-fold [95%CI, 2.9-4.6] higher risk of death at 2 years compared with controls. They also had a 2-fold increase in both healthcare utilization and frailty score in the 2 years after hospital discharge, whereas healthcare utilization and frailty scores among controls were stable before and after hospitalisation.
Conclusions We observed a substantially increased rate of death in the years following ICU-hospitalisation for elderly patients along with elevated healthcare resource use and accelerated age-associated decline as assessed by frailty score. These findings provide data for better informed goals-of-care discussions and may help target post-ICU discharge services.
Funding: None
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Long-term survival of elderly patients after intensive care unit admission for acute respiratory infection: a population-based, propensity-score matched cohort study.
Posted 17 Jun, 2020
On 29 Jun, 2020
On 16 Jun, 2020
On 16 Jun, 2020
On 15 Jun, 2020
On 15 Jun, 2020
On 01 Jun, 2020
On 31 May, 2020
Received 31 May, 2020
Received 12 May, 2020
On 11 May, 2020
Invitations sent on 09 May, 2020
On 09 May, 2020
On 09 May, 2020
Received 09 May, 2020
Received 09 May, 2020
On 30 Apr, 2020
On 29 Apr, 2020
On 29 Apr, 2020
On 25 Mar, 2020
Received 24 Mar, 2020
On 13 Mar, 2020
Received 03 Mar, 2020
Received 20 Feb, 2020
Received 11 Feb, 2020
On 10 Feb, 2020
On 09 Feb, 2020
Invitations sent on 08 Feb, 2020
On 08 Feb, 2020
On 05 Feb, 2020
On 04 Feb, 2020
On 04 Feb, 2020
On 31 Jan, 2020
Background Intensive care unit (ICU) hospitalisations of elderly patients with acute respiratory infection have increased, yet the long-term effects of ICU admission among elderly individuals remain unknown. We examined differences over the two years after discharge in mortality, healthcare utilization and frailty score between elderly survivors of ARI in the ICU and an elderly control population.
Methods We used 2009-2017 data from 39 hospital discharge databases. Patients ≥80 years old discharged alive from ICU-hospitalisation for acute respiratory infection were propensity-score matched with controls (cataract surgery) discharged from the hospital at the same time and adjusted for age, sex and comorbidities present before hospitalisation. We reported 2-year mortality and compared healthcare utilization and frailty scores in the 2-year periods before and after ICU-hospitalisation.
Results 1,220 elderly survivors of acute respiratory infection in the ICU were discharged, and 988 were successfully matched with controls. After discharge, patients had a 10.1-fold [95%CI, 6.1-17.3] higher risk of death at 6 months and 3.6-fold [95%CI, 2.9-4.6] higher risk of death at 2 years compared with controls. They also had a 2-fold increase in both healthcare utilization and frailty score in the 2 years after hospital discharge, whereas healthcare utilization and frailty scores among controls were stable before and after hospitalisation.
Conclusions We observed a substantially increased rate of death in the years following ICU-hospitalisation for elderly patients along with elevated healthcare resource use and accelerated age-associated decline as assessed by frailty score. These findings provide data for better informed goals-of-care discussions and may help target post-ICU discharge services.
Funding: None
Figure 1
Figure 2
Figure 3