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Epidemiology
The impact of age on mortality in the intensive care unit: a retrospective cohort study in Malaysia
Abdul Jabbar Ismail, W Mohd Nazaruddin W Hassan, Mohd Basri Mat Nor, Wan Fadzlina Wan Muhd Shukeri
Acute Crit Care. 2024;39(3):390-399.   Published online August 12, 2024
DOI: https://doi.org/10.4266/acc.2024.00640
  • 1,276 View
  • 185 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Age is a significant consideration for intensive care unit (ICU) admission. However, the reported associations between increasing age and mortality vary across studies, and data in the local context of Malaysia are lacking. The objective of the present study was to determine the impact of increasing age on ICU mortality.
Methods
A retrospective cohort study of ICU patients was conducted between January 2020 and November 2023 at a university hospital in Malaysia. Patients were classified into two categories according to age (years) and into four groups according to National Library of Medicine Medical Subject Headings (MeSH): young adult (19–24), adult (25–44), middle age (45–64), and elderly (≥65). The Cochran-Armitage test for trend and Cox proportional hazards regression analyses were performed to evaluate the impact of increasing age on ICU mortality.
Results
A total of 1,661 patients was analyzed. The Cochran-Armitage test showed a significant positive association between ICU mortality rate and age group (Z=−4.86, P<0.01) or MeSH category (Z=−5.36, P<0.01). After adjusting for other confounders, the strongest predictor for ICU mortality in the Cox proportional hazards regression analyses was age, with the elderly age group having the highest adjusted hazard ratio of 4.777 (95% CI, 1.128–20.231; P=0.03).
Conclusions
Age had a significant impact on ICU mortality in our cohort of critically ill patients.

Citations

Citations to this article as recorded by  
  • Early Mortality Prediction in Intensive Care Unit Patients Based on Serum Metabolomic Fingerprint
    Rúben Araújo, Luís Ramalhete, Cristiana P. Von Rekowski, Tiago A. H. Fonseca, Luís Bento, Cecília R. C. Calado
    International Journal of Molecular Sciences.2024; 25(24): 13609.     CrossRef
Rapid response system
Demographic Changes in Intensive Care Units in Korea over the Last Decade and Outcomes of Elderly Patients: A Single-Center Retrospective Study
Jeong Uk Lim, Jongmin Lee, Jick Hwan Ha, Hyeon Hui Kang, Sang Haak Lee, Hwa Sik Moon
Korean J Crit Care Med. 2017;32(2):164-173.   Published online May 31, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00668
  • 7,568 View
  • 116 Download
  • 11 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Background
Aging is a significant issue worldwide, and Korea is one of the most rapidly aging countries. Along with the demographic transition, the age structure of intensive care unit (ICU) patients changes as well.
Methods
The aim of this study was to analyze the change in age distribution of the ICU patients over the last 10 years and its effect on clinical outcomes. Single-center, retrospective analysis of all patients aged ≥18 years admitted to either the medical or surgical ICU at St. Paul’s Hospital, The Catholic University of Korea, between January 2005 and December 2014 was conducted. For clinical outcome, in-hospital mortality, duration of ICU stay, and hospital stay were analyzed. Cost analysis was performed to show the economic burden of each age strata.
Results
A total of 10,366 ICU patients were admitted to the chosen ICUs during the study period. The proportion of elderly patients aged ≥65 years increased from 47.9% in 2005 to 63.7% in 2014, and the proportion of the very elderly patients aged ≥80 years increased from 12.8% to 20.7%. However, this increased proportion of elderly patients did not lead to increased in-hospital mortality. The percent of ICU treatment days attributable to elderly patients increased from 51.1% in year 2005 to 64.0% in 2014. The elderly ICU patients were associated with higher in-hospital mortality compared to younger age groups.
Conclusions
The proportion of elderly patients admitted to ICUs increased over the last decade. However, overall in-hospital mortality has not increased during the same period.

Citations

Citations to this article as recorded by  
  • Korean Guidelines for the Management and Antibiotic Therapy in Adult Patients with Hospital-Acquired Pneumonia
    Hayoung Choi, Kyung Hoon Min, Young Seok Lee, Youjin Chang, Bo Young Lee, Jee Youn Oh, Ae-Rin Baek, Jongmin Lee, Kyeongman Jeon
    Tuberculosis and Respiratory Diseases.2025; 88(1): 69.     CrossRef
  • Ethical issues surrounding appropriate care for older persons in the Intensive Care Unit
    Jean-Louis VINCENT
    Panminerva Medica.2024;[Epub]     CrossRef
  • Age Distribution and Clinical Results of Critically Ill Patients above 65-Year-Old in an Aging Society: A Retrospective Cohort Study
    Song I Lee, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim
    Tuberculosis and Respiratory Diseases.2024; 87(3): 338.     CrossRef
  • The impact of age on mortality in the intensive care unit: a retrospective cohort study in Malaysia
    Abdul Jabbar Ismail, W Mohd Nazaruddin W Hassan, Mohd Basri Mat Nor, Wan Fadzlina Wan Muhd Shukeri
    Acute and Critical Care.2024; 39(3): 390.     CrossRef
  • Impact of lipopolysaccharide-induced acute lung injury in aged mice
    Sukjin Bae, In Kyoung Kim, Jeonghyeon Im, Heayon Lee, Sang Haak Lee, Sei Won Kim
    Experimental Lung Research.2023; 49(1): 193.     CrossRef
  • Perfil de mortalidade de idosos jovens hospitalizados em uma unidade de terapia intensiva
    Jeferson Moreira dos Santos, Ricardo Franklin De Freitas Mussi , Jessica Lane Pereira Santos , Larissa Chaves Pedreira Silva, Maria Antônia Alves de Souza
    Ciência, Cuidado e Saúde.2023;[Epub]     CrossRef
  • Characteristics and prognostic factors of very elderly patients admitted to the intensive care unit
    Song-I Lee, Younsuck Koh, Jin Won Huh, Sang-Bum Hong, Chae-Man Lim
    Acute and Critical Care.2022; 37(3): 372.     CrossRef
  • Challenges Experienced by Family Caregivers of the Adult Intensive Care Unit Patients in Korea: An Integrative Review
    JiYeon Choi, Judith A. Tate, Youn-Jung Son
    Clinical Nursing Research.2021; 30(4): 423.     CrossRef
  • Retrospective Analysis of Long-Term Survival in Very Elderly (age ≥80) Critically Ill Patients of a Medical Intensive Care Unit at a Tertiary Care Hospital in Korea
    Seung Hun Lee, Ju-Young Kim, Tae Hoon Kim, Sun Mi Ju, Jung-Wan Yoo, Seung Jun Lee, Yu Ji Cho, Yi Yeong Jeong, Jong Deog Lee, Ho Cheol Kim
    Tuberculosis and Respiratory Diseases.2020; 83(3): 242.     CrossRef
  • Should Very Old Patients Be Admitted to the Intensive Care Units?
    Jun Kwon Cha, In-Ae Song
    The Korean Journal of Critical Care Medicine.2017; 32(4): 376.     CrossRef
Cardiology/Pulmonary
Clinical Characteristics of Respiratory Extracorporeal Life Support in Elderly Patients with Severe Acute Respiratory Distress Syndrome
Woo Hyun Cho, Dong Wan Kim, Hye Ju Yeo, Seong Hoon Yoon, Seung Eun Lee, Doo Soo Jeon, Yun Seong Kim, Bong Soo Son, Do Hyung Kim
Korean J Crit Care Med. 2014;29(4):266-272.   Published online November 30, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.4.266
  • 4,949 View
  • 51 Download
  • 1 Crossref
AbstractAbstract PDF
BACKGROUND
Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS.
METHODS
We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group.
RESULTS
From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock.
CONCLUSIONS
In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.

Citations

Citations to this article as recorded by  
  • Venovenous Extracorporeal Membrane Oxygenation for Negative Pressure Pulmonary Hemorrhage in an Elderly Patient
    Kenichiro Ishida, Mitsuhiro Noborio, Nobutaka Iwasa, Taku Sogabe, Yohei Ieki, Yuki Saoyama, Kyosuke Takahashi, Yumiko Shimahara, Daikai Sadamitsu
    Case Reports in Critical Care.2015; 2015: 1.     CrossRef
Trauma
Mortality and Morbidity in Severely Traumatized Elderly Patients
Byungchul Yu, Min Chung, Giljae Lee, Jungnam Lee
Korean J Crit Care Med. 2014;29(2):88-92.   Published online May 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.2.88
  • 5,278 View
  • 69 Download
  • 4 Crossref
AbstractAbstract PDF
Background
As the population ages, the elderly will constitute a prominent proportion of trauma patients. The elderly suffer more severe outcomes from injuries compared with the young. In this study, we examined the relationship between mortality and complications with age.
Methods
This study was a retrospective review of 256 major trauma patients (Injury Severity Score > 15) admitted to an emergency center over a two- year period. Age-dependent mortality and complications were evaluated.
Results
Of 256 patients, 209 (81.6%) were male and the mean age was 47.2 years. There was a trend between increasing age and increasing mortality, but this was not statistically significant. Increasing age was correlated with frequency of complications.
Conclusions
Age was confirmed to be an independent predictor of mortality in major trauma. We documented that elderly trauma patients suffer from complications more frequently compared with their younger counterparts. Appropriate and specific triage and management guidelines for elderly trauma patients are needed.

Citations

Citations to this article as recorded by  
  • Predicting mortality in elderly trauma patients: a review of the current literature
    Jarva Chow, Catherine M. Kuza
    Current Opinion in Anaesthesiology.2022; 35(2): 160.     CrossRef
  • Activities of Daily Living and Determinant Factors among Older Adult Subjects with Lower Body Fracture after Discharge from Hospital: A Prospective Study
    Nurul Izzah Ibrahim, Mohd Sharkawi Ahmad, Mohamed S Zulfarina, Sharifah Nurul Aqilah Sayed Mohd Zaris, Isa Naina Mohamed, Norazlina Mohamed, Sabarul Afian Mokhtar, Ahmad Nazrun Shuid
    International Journal of Environmental Research and Public Health.2018; 15(5): 1002.     CrossRef
  • Geriatric Trauma Protocol
    Renee Cortez
    Journal of Trauma Nursing.2018; 25(4): 218.     CrossRef
  • Predictive Factors of Dependency in Activities of Daily Living Following Limb Trauma in the Elderly
    Azade Safa, Negin Masoudi Alavi, Masoumeh Abedzadeh-Kalahroudi
    Trauma Monthly.2016;[Epub]     CrossRef

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