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Long term outcomes for elderly patients after emergency intensive care admission: A cohort study

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  • Ged Dempsey
  • Dan Hungerford
  • Phil McHale
  • Lauren McGarey
  • Edward Benison
  • Ben Morton

Abstract

Background: Elderly patients (≥ 80 years of age) surviving an episode of critical illness suffer long-term morbidity and risk of mortality. Identifying high risk groups could assist in informing discussions with patients and families. Aim: To determine factors associated with long-term survival following ICU admission. Design: A cohort study of patients aged ≥ 80 years of age admitted to the ICU as an emergency. Methods: Patients admitted from January 2010 to December 2018 were included in the study. Primary outcome was five year survival. Mortality was assessed using a multivariable flexible parametric survival analysis adjusted for demographics, and clinically relevant covariates. Results: There were 828 patients. Mean age was 84 years (SD 3.2) and 419 (51%) were male. Patients were categorised into medical (423 (51%)) and surgical (405 (49%)) admissions. Adjusted hazard ratios (aHR) for mortality were highest for serum lactate (>8 mmol/l aHR 2.56 (C.I. 1.79–3.67)), lowest systolic blood pressure ( 8 mmol/l respectively). Relative survival for medical patients was below that expected for the general population for the duration of the study. Conclusion: Overall five-year survival was 27%. For medical and surgical patients it was 19% and 35% respectively. Survival at 30 days and one year was 61% and 46%. The presence of features of circulatory shock predicted poor short and long term survival.

Suggested Citation

  • Ged Dempsey & Dan Hungerford & Phil McHale & Lauren McGarey & Edward Benison & Ben Morton, 2020. "Long term outcomes for elderly patients after emergency intensive care admission: A cohort study," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-14, October.
    • Handle: RePEc:plo:pone00:0241244
    DOI: 10.1371/journal.pone.0241244
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    References listed on IDEAS

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    1. Paul W. Dickman & Enzo Coviello, 2015. "Estimating and modeling relative survival," Stata Journal, StataCorp LP, vol. 15(1), pages 186-215, March.
    2. Paul C. Lambert & Patrick Royston, 2009. "Further development of flexible parametric models for survival analysis," Stata Journal, StataCorp LP, vol. 9(2), pages 265-290, June.
    3. Xudong Du & Mier Li & Ping Zhu & Ju Wang & Lisha Hou & Jijie Li & Hongdao Meng & Muke Zhou & Cairong Zhu, 2018. "Comparison of the flexible parametric survival model and Cox model in estimating Markov transition probabilities using real-world data," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-13, August.
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