What are the prognostic factors affecting 30-day mortality in geriatric patients with respiratory failure in the Intensive Care Unit?

Mustafa Özgür Cirik,Derya Yenibertiz

doi:10.12669/pjms.37.1.3189

Abstract

Objective:We aimed to investigate the prognostic factors related to 30 day mortality of elderly patients with respiratory failure in the intensive care unit (ICU).Methods:We performed a single centre, retrospective study and analyzed the main variables and outcomes of 238 geriatric patients admitted to an ICU with ARF between December 2017- January 2019 in Chest Disease Hospital, were included and classified as survivors and nonsurvivors. Main characteristics, laboratory datas, severity and nutrition scores were evaluated and logistic regression analysis were used.Results:The nonsurvivor group included 110 cases (40% female,) with a median age of 79, had higher scores in the followings; Acute Physiology Chronic Health Evaluation II score (APACHE-II) (p < 0.001), Charlson Comorbidity Index (CCI) (p < 0.001), Sequential Organ Failure Assessment score (p < 0.001). The inotropic support requirement was also higher in the nonsurvivor group (48,2%). As a comorbidity, malignancy and Type-I respiratory failure were higher in the nonsurvivor group (p=0.03, p < 0.001). The overall 30-day mortality was 46%. Blood urea nitrogen, procalsitonin, C-reactive protein and creatinine levels were higher in the nonsurvivor group (p < 0.001). However, albumin (p < 0.001), BMI (p=0.03) and longer hospital stay (p < 0.001) were higher in the survivor group. Inotropic support, APACHE-II score and CCI were independently related to increased mortality risk, whereas albumin was associated with decreased mortality risk.Conclusion:High APACHE II score, low CCI, low albumin levels and the requirement for inotropic support were found to be independently risk factors of 30-day mortality in the geriatric patients with respiratory failure in ICU.

Highlights

With the increasing of longevity, the geriatric population has been rising all over the world in the past few decades
We aimed to investigate the outcomes of geriatric patients treated for acute respiratory failure (ARF) in the intensive care unit (ICU) and to determine the prognostic factors related with 30-day mortality rate in this study
Patients were classified into two groups; survivors and non-survivors according to 30-day mortality

Summary

Introduction

With the increasing of longevity, the geriatric population has been rising all over the world in the past few decades. The World Health Organization (WHO) declared that by 2050, approximately 16% of the world population, will be equal or more than 65 years old.[1] These elderly population are representing majority of the patients admitted to ICU.[2] The incidence of acute respiratory failure (ARF), the major indication of hospitalization in the ICU, increases exponentially with age.[3,4,5] The relationship between prognosis and the age of the critically ill patients has been investigated in detail for. Diseases have atypical presentations in the geriatric population and there are lots of co-morbidities that increase the mortality rate for in this age group

Methods

Results

Conclusion