Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality

Background: Unplanned admission to the intensive care unit has been shown to significantly increase the risk of in-hospital mortality. Medical advances and increased expectations have resulted in a greater number of very elderly patients (80 years and over) being admitted to the ICU. The risk of in-...

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Main Authors: Frost, S., Davidson, Patricia, Alexandrou, Evan, Hunt, L., Salamonson, Y., Tam, V., Parr, M., Aneman, A., Hillman, K.
Format: Journal Article
Published: College of Intensive Care Medicine 2010
Online Access:http://hdl.handle.net/20.500.11937/42721
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author Frost, S.
Davidson, Patricia
Alexandrou, Evan
Hunt, L.
Salamonson, Y.
Tam, V.
Parr, M.
Aneman, A.
Hillman, K.
author_facet Frost, S.
Davidson, Patricia
Alexandrou, Evan
Hunt, L.
Salamonson, Y.
Tam, V.
Parr, M.
Aneman, A.
Hillman, K.
author_sort Frost, S.
building Curtin Institutional Repository
collection Online Access
description Background: Unplanned admission to the intensive care unit has been shown to significantly increase the risk of in-hospital mortality. Medical advances and increased expectations have resulted in a greater number of very elderly patients (80 years and over) being admitted to the ICU. The risk of in-hospital death associated with unplanned admission to the ICU in very elderly patients has not been clearly defined. Objective: To estimate the risk of in-hospital mortality associated with unplanned admission to the ICU in patients aged 80 years and over. Design, setting and participants: Retrospective review of an adult intensive care database. The setting was Liverpool Hospital, a large teaching hospital in Sydney, Australia, witha 28-bed ICU that has about 2000 admissions per year. We analysed data on very elderly patients (n = 1680), aged 80years or more, admitted to the ICU between 1 January 1997 and 31 December 2007.Main outcome measures: Baseline risk factors for in-hospital mortality. Results: Mortality among patients with unplanned ICU admissions was 47%, compared with 25% in patients with planned admissions (adjusted rate ratio [RR], 1.92 [95% CI,1.59-2.32]). An estimated 50% of the overall risk of in-hospital death among very elderly patients was attributable to a combination of unplanned admission to the ICU, the presence of at least one comorbid condition, acute renal failure and respiratory failure requiring intubation. Conclusion: Unplanned admission to the ICU increases the risk of in-hospital mortality in very elderly patients. At least 50% of the risk of in-hospital death in this age group is attributable to a combination of unplanned ICU admission, comorbidity (1 comorbid condition), acute renal failure and respiratory failure.
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spelling curtin-20.500.11937-427212017-01-30T15:01:39Z Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality Frost, S. Davidson, Patricia Alexandrou, Evan Hunt, L. Salamonson, Y. Tam, V. Parr, M. Aneman, A. Hillman, K. Background: Unplanned admission to the intensive care unit has been shown to significantly increase the risk of in-hospital mortality. Medical advances and increased expectations have resulted in a greater number of very elderly patients (80 years and over) being admitted to the ICU. The risk of in-hospital death associated with unplanned admission to the ICU in very elderly patients has not been clearly defined. Objective: To estimate the risk of in-hospital mortality associated with unplanned admission to the ICU in patients aged 80 years and over. Design, setting and participants: Retrospective review of an adult intensive care database. The setting was Liverpool Hospital, a large teaching hospital in Sydney, Australia, witha 28-bed ICU that has about 2000 admissions per year. We analysed data on very elderly patients (n = 1680), aged 80years or more, admitted to the ICU between 1 January 1997 and 31 December 2007.Main outcome measures: Baseline risk factors for in-hospital mortality. Results: Mortality among patients with unplanned ICU admissions was 47%, compared with 25% in patients with planned admissions (adjusted rate ratio [RR], 1.92 [95% CI,1.59-2.32]). An estimated 50% of the overall risk of in-hospital death among very elderly patients was attributable to a combination of unplanned admission to the ICU, the presence of at least one comorbid condition, acute renal failure and respiratory failure requiring intubation. Conclusion: Unplanned admission to the ICU increases the risk of in-hospital mortality in very elderly patients. At least 50% of the risk of in-hospital death in this age group is attributable to a combination of unplanned ICU admission, comorbidity (1 comorbid condition), acute renal failure and respiratory failure. 2010 Journal Article http://hdl.handle.net/20.500.11937/42721 College of Intensive Care Medicine fulltext
spellingShingle Frost, S.
Davidson, Patricia
Alexandrou, Evan
Hunt, L.
Salamonson, Y.
Tam, V.
Parr, M.
Aneman, A.
Hillman, K.
Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality
title Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality
title_full Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality
title_fullStr Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality
title_full_unstemmed Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality
title_short Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality
title_sort unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality
url http://hdl.handle.net/20.500.11937/42721