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1/2024
vol. 56
abstract:
Original article
Predictors of outcomes of patients ≥ 80 years old admitted to intensive care units in Poland – a post-hoc analysis of the VIP2 prospective observational study
Paweł Melchior Pasieka
1
,
Joanna Sołek-Pastuszka
9
,
Małgorzata Zegan-Barańska
12
,
Mirosław Ziętkiewicz
10, 18
,
Paweł Nasiłowski
21, 22
,
Waldemar Cyrankiewicz
27
,
Katarzyna Sierakowska
27, 28
,
1.
Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland
2.
Department of Anaesthesiology, Intensive Therapy and Pain Treatment, Poznan University of Medical Sciences, Poznan, Poland
3.
Department of Teaching Anaesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
4.
Clinical Department of Anaesthesiology and Intensive Care, University Hospital in Zielona Gora, Poland
5.
Department of Anaesthesiology and Critical Care, School of Medicine with Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
6.
Department of Anaesthesiology and Intensive Care, St. John Grande Hospital in Krakow, Poland
7.
Department of Anaesthesiology and Intensive Care, University Clinical Centre, School of Medicine in Katowice – Medical University of Silesia, Katowice, Poland
8.
Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Medical University of Gdansk, Poland
9.
Department of Clinical Anaesthesiology and Intensive Therapy, Pomeranian Medical University SPSK 1, Szczecin, Poland
10.
Department of Anaesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Krakow, Poland
11.
Anesthesia and Intensive Care Unit, Regional Health Centre in Lublin, Poland
12.
Department of Anaesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Poland
13.
Anaesthesia and Intensive Care Unit, 4th Military Hospital in Wroclaw, Poland
14.
Department of Anaesthesiology and Intensive Therapy, Ludwik Rydygier Memorial Specialist Hospital in Krakow, Poland
15.
Department of Anaesthesiology and Intensive Therapy – Centre for Artificial Extracorporeal Kidney and Liver Support, Lodz, Poland
16.
Department of Anaesthesiology and Intensive Therapy, Central Teaching Hospital of the Medical University of Lodz, Poland
17.
2nd Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Poland
18.
2nd Department of Anaesthesiology and Intensive Care, John Paul II Hospital in Krakow, Poland
19.
Department of Anaesthesiology and Intensive Therapy, Wroclaw University Hospital, Wroclaw Medical University, Wroclaw, Poland
20.
Clinical Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
21.
Department of Anaesthesiology and Intensive Therapy, G. Narutowicz Specialist Hospital in Krakow, Poland
22.
Department of Anaesthesiology and Intensive Care, St. Ann Hospital in Miechow, Poland
23.
I Department of Anaesthesiology and Intensive Care, University Clinical Center of the Medical University of Warsaw – Infant Jesus Clinical Hospital, Warsaw, Poland
24.
Department of Anaesthesiology and Intensive Care, Regional Hospital in Bialystok, Poland
25.
Department of Anaesthesiology and Intensive Care, Institute of Medical Sciences, University of Opole, Poland
26.
Department of Anaesthesiology and Intensive Care, Medical University of Bialystok, Poland
27.
Department of Anaesthesiology and Intensive Therapy, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
28.
Department of Anaesthesiology and Intensive Therapy, Nicolaus Copernicus University Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland
29.
Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
30.
1st Department of Anaesthesiology and Intensive Care, John Paul II Hospital in Krakow, Poland
31.
Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
32.
Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
Anaesthesiol Intensive Ther 2024; 56, 1: 61–69
Online publish date: 2024/03/29
PlumX metrics:
Introduction:
Elderly patients pose a significant challenge to intensive care unit (ICU) clinicians. In this study we attempted to characterise the population of patients over 80 years old admitted to ICUs in Poland and identify associations between clinical features and short-term outcomes.
Material and methods:
The study is a post-hoc analysis of the Polish cohort of the VIP2 European prospective observational study enrolling patients > 80 years old admitted to ICUs over a 6-month period. Data including clinical features, clinical frailty scale (CFS), geriatric scales, interventions within the ICU, and outcomes (30-day and ICU mortality and length of stay) were gathered. Univariate analyses comparing frail (CFS > 4) to non-frail patients and survivors to non-survivors were performed. Multivariable models with CFS, activities of daily living score (ADL), and the cognitive decline questionnaire IQCODE as predictors and ICU or 30-day mortality as outcomes were formed.
Results:
A total of 371 patients from 27 ICUs were enrolled. Frail patients had significantly higher ICU (58% vs. 44.45%, P = 0.03) and 30-day (65.61% vs. 54.14%, P = 0.01) mortality compared to non-frail counterparts. The survivors had significantly lower SOFA score, CFS, ADL, and IQCODE than non-survivors. In multivariable analysis CFS (OR 1.15, 95% CI: 1.00–1.34) and SOFA score (OR 1.29, 95% CI: 1.19–1.41) were identified as significant predictors for ICU mortality; however, CFS was not a predictor for 30-day mortality (P = 0.07). No statistical significance was found for ADL, IQCODE, polypharmacy, or comorbidities.
Conclusions:
We found a positive correlation between CFS and ICU mortality, which might point to the value of assessing the score for every patient admitted to the ICU. The older Polish ICU patients were characterised by higher mortality compared to the other European countries.
keywords:
sepsis, intensive care, observational study, prospective study, multicentre study, frailty, geriatric population, mortality analysis, VIP study
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