Abstract
Patients in critical care medicine are ageing. There is limited literature evaluating long-term outcomes and prognostic factors for the growing number of elderly patients with acute respiratory failure (ARF) receiving invasive mechanical ventilation (IMV). Data on elderly patients (≧ 65 years old) with ARF receiving intubation and IMV during 2003–2012 were retrospectively collected from the national health database in Taiwan. We included 7,095 elderly patients. The 28-day mortality was 33%, the 60-day mortality was 47.5%, and the 1-year mortality was 70.4%. Patients were divided into groups: young-old (65–74 years), middle-old (75–84 years), and oldest-old (≧ 85 years). Patients in the oldest-old and middle-old groups had higher 1-year mortality than the young-old group (p < 0.001). The multivariate logistic regression revealed 9 significant factors associated with 1-year mortality, and these factors were used to develop a prognostic nomogram. The present study showed that the long-term prognosis of elderly patients with ARF and IMV is very poor. This nomogram can help physicians estimate the 1-year mortality of elderly patients in the early stage of ARF and assist in clinical decision making.
Highlights
Patients in critical care medicine are ageing
This study showed that the mean 1-year mortality of elderly critical patients with invasive mechanical ventilation (IMV) is as high as 70%, and the outcome is poorer in the oldest-old group
We developed a nomogram by using 9 baseline clinical factors to predict 1-year mortality of elderly patients with IMV
Summary
There is limited literature evaluating long-term outcomes and prognostic factors for the growing number of elderly patients with acute respiratory failure (ARF) receiving invasive mechanical ventilation (IMV). Among elderly critical patients in ICU, invasive mechanical ventilation (IMV) is one of the most important factors predicting poor short-term (30 days) and long-term (1 year) o utcomes[5]. Previous literature reports a striking 1-year mortality rate of 72.5% in elderly critical patients ≧ 65 years old and receiving I MV8. Even for those who survived critical illness and were discharged, increase in disability and need for long-term care were serious issues. A reliable prognosis tool predicting outcomes in critical elderly patients with IMV is required to assist clinical decision making
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