Abstract
Acute respiratory distress syndrome (ARDS) has a high mortality rate in intensive care units (ICU). The elderly patients remain to be increased of ICU patients. The aim is to investigate the survival predictors of elderly patients with ARDS. We reported a prospective observational cohort research, including the patients with ARDS between October 2012 and May 2015. Demographic, comorbidities, severity, lung mechanics, laboratory data and survival outcomes were analyzed. A total of 463 patients with ARDS were ≥65 years old were enrolled and analyzed. Multivariate logistic regression analysis identified Charlson comorbidity index (CCI) [odds ratio (OR) 1.111, 95% CI 1.010–1.222, p = 0.031], Sequential Organ Failure Assessment (SOFA) score (OR 1.127, 95% CI 1.054–1.206, p < 0.001) and peak inspiratory pressure (PIP) (OR 1.061, 95% CI 1.024–1.099, p = 0.001) which were independently associated with hospital mortality. Regarding the subgroups patients as 65–74 years old, 75–84 years old and ≥85 years old, the baseline characteristics were not significant difference and the hospital mortality rates were also not significant difference. In conclusion, CCI, SOFA score and PIP were identified as survival predictors in elderly patient with ARDS. Assessing comorbidities with CCI is essential in predicting the survival for elderly patients with ARDS.
Highlights
Some epidemiological studies have reported that acute respiratory distress syndrome (ARDS) accounts for 4% of all hospital admissions1,2, 10.4% of intensive care unit (ICU) admissions, and 23.4% of patients needed mechanical ventilation for more than 4 weeks[3]
The main results of this prospective observational cohort study revealed that the older (≥65 years old) patients with ARDS had a lower survival rate than the younger (
The Berlin definition classifies the severity of ARDS by the PaO2/FiO2 ratio, and mild, moderate, and severe ARDS are associated with increased mortality (27%, 32% and 45%, respectively)[1]
Summary
Some epidemiological studies have reported that acute respiratory distress syndrome (ARDS) accounts for 4% of all hospital admissions1,2, 10.4% of intensive care unit (ICU) admissions, and 23.4% of patients needed mechanical ventilation for more than 4 weeks[3]. Previous studies have reported that the mortality rate of ARDS among elderly patients may be as high as 69–80%5,6. Several studies have concluded that age is not a predictor of a poor prognosis for elderly patients admitted to an ICU, and that severity of chronic illness and premorbid functional status mainly decided the patients’ outcomes[9,10,11]. Few studies have investigated the role of advanced age on the survival outcomes of patients with ARDS. The object of this study was to explore the survival predictors of elderly patients with ARDS. Understanding these factors may help intensivists when making decisions regarding the appropriate use of life support in this particular patient population
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call