Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU
De Lange, Dylan W.. (University Medical Center, University Utrecht)
Brinkman, Sylvia (Amsterdam UMC. University Medical Center)
Flaatten, Hans (Haukeland University Hospital (Bergen, Noruega))
Boumendil, Ariane (Assistance Publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Service de Réanimation Médicale)
Morandi, Alessandro (Geriatric Research Group)
Andersen, Finn H. (NTNU)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Bertolini, Guido (Centro di Coordinamento GiViTI Dipartimento di Salute Pubblica, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri")
Cecconi, Maurizio (St George's University Hospital)
Christensen, Steffen (Aarhus University Hospital (Aarhus, Dinamarca))
Faraldi, Loredana (ASST Grande Ospedale Metropolitano Niguarda)
Fjølner, Jesper (Aarhus University Hospital (Aarhus, Dinamarca))
Jung, Christian (University Hospital)
Marsh, Brian (Mater Misericordiae University Hospital(Dublín, Irlanda))
Moreno, Rui (Hospital de São José, Centro Hospitalar Universitário de Lisboa Central Nova Medical School)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Öhman, Christina Agvald (Karolinska University Hospital and Karolinska Institutet (Suècia))
Bollen Pinto, Bernardo (Geneva University Hospitals (Suïssa))
de Smet, Anne Marie G. A. (University Medical Center Groningen, University Groningen)
Soliman, Ivo W. (University Medical Center, University Utrecht)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Valentin, Andreas (Kardinal Schwarzenberg Hospital (Àustria))
Watson, Ximena (St George's University Hospital)
Zafeiridis, Tilemachos (General University Hospital of Larissa (Grècia))
Guidet, Bertrand (ICU, hospital Saint Antoine, APHP)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). Prospective cohort study. A total of 306 ICUs from 24 European countries. Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81-87 y]; 51. 8% male). Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30-day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves. The 30-day-mortality was 1562 (41. 9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis, Clinical Frailty Scale, Sequential Organ Failure Score, invasive mechanical ventilation, and renal replacement therapy. The discrimination, accuracy, and calibration of the model were good: the area under the curve for a score of 10 or higher was. 80, and the Brier score was. 18. At a cut point of 10 or higher (75% of all patients), the model predicts 30-day mortality in 91. 1% of all patients who die. A predictive model of cumulative events predicts 30-day mortality in patients older than 80 years admitted to ICUs. Future studies should include other potential predictor variables including functional status, presence of advance care plans, and assessment of each patient's decision-making capacity.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Critical care ; Prognosis ; Older adults ; Predict ; Model
Publicat a:	Journal of the American Geriatrics Society, Vol. 67 Num. 6 (June 2019) , p. 1263-1267, ISSN 1532-5415

DOI: 10.1111/jgs.15888
PMID: 30977911

5 p, 145.5 KB

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