Acute respiratory infection hospitalized in intensive care unit: long-term outcome in Elderly

Abstract Background The consequences of the ageing population concerning ICU-hospitalization need to be adequately described, especially acute respiratory infections (ARI) strongly associated with Elderly. The study aimed to assess the long-term outcomes of ARI surviving ICU hospitalization in patients over 80 yo. Methods A retrospective multicentre cohort study was performed, based on hospital discharge databases in one French region (2.5 million inhabitants). Patients with ARI in ICU were selected according to specific ICD-10 diagnosis codes recorded and matched with a control population (patient undergoing a cataract surgery), using a propensity score (matching algorithm 1:1 ratio, caliper 0.002) with the matching variables (age, sex, frailty score, chronic heart disease, chronic pulmonary disease and cancer). Analyzes of this matched population were performed to determine their 2-year in-hospital mortality, healthcare utilization and evolution of the frailty score during the 2-year period before/after the inclusion stay. Results A total of 1,658 hospital stays for ARI after 80 yo were identified, with 438 dead (26%) during the initial stay. After matching with the cataract population, 988 patients were selected in each group without difference in the propensity score. ARI lead to an important increase of healthcare use during the 2 years after discharge. The patients that were discharged from hospital after ARI requiring ICU, had a 23-fold increase of death at 90 days and 4-fold at 2 years and the evolution of the frailty score was 1.6 fold higher than the cataract population. Conclusions Elderly patients with severe ARI survived from their ICU stay in 75%, but have a major risk of death in the following months, and an important increase in healthcare consumption. Our findings provide data for more informed goals-of-care discussions and may help target post-ICU discharge services for these high-risk groups. Key messages Elderly patients with severe acute respiratory infection survived ICU in 75%, but had a major risk of death in the following months, added to a substantial increase in healthcare consumption. These findings provide data for more informed goals-of-care discussions and may help target interventions for these high-risk groups.

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Long-term survival of elderly patients after intensive care unit admission for acute respiratory infection: a population-based, propensity-score matched cohort study.

10.21203/rs.2.22685/v1 ◽

2020 ◽

Author(s):

Antoine Guillon ◽

C. Hermetet ◽

K. A. Barker ◽

Y. Jouan ◽

C. Gaborit ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Elderly Patients ◽

Healthcare Utilization ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Risk Of Death ◽

Before And After ◽

Frailty Score

Abstract BackgroundIntensive care unit (ICU) hospitalisations of elderly patients with acute respiratory infection (ARI) have increased, yet the long-term effect of ICU admission among elderly individuals remain unknown. We examined differences over the two years after discharge in mortality, healthcare utilization and frailty score between elderly survivors of ARI in the ICU and an elderly control population.MethodsWe used 2009-2017 data from 39 hospital discharge databases. Patients ≥80 years old discharged alive from ICU-hospitalisation for acute respiratory infection were propensity-score matched with controls (cataract surgery) discharged from the hospital at the same time and adjusted for age, sex and comorbidities present before hospitalisation. We reported 4-year mortality and compared healthcare utilization and frailty scores in the 2-year periods before and after ICU-hospitalisation.Results1,220 elderly survivors of acute respiratory infection in the ICU were discharged, and 988 were successfully matched with controls. After discharge, patients had a 10.1-fold [95%CI, 6.1-17.3] higher risk of death at 6 months and 3.6-fold [95%CI, 2.9-4.6] higher risk of death at 2 years compared with controls. They also had a 2-fold increase in both healthcare utilization and frailty score in the 2 years after hospital discharge, whereas healthcare utilization and frailty scores among controls were stable before and after hospitalisation.ConclusionsWe observed a substantially increased rate of death in the years after ICU-hospitalisation for elderly patients along with elevated healthcare resource use and accelerated age-associated decline as assessed by frailty score. These findings provide data for better informed goals-of-care discussions and may help target post-ICU discharge services.

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Long-term survival of elderly patients after intensive care unit admission for acute respiratory infection: a population-based, propensity-score matched cohort study.

10.21203/rs.2.22685/v2 ◽

2020 ◽

Author(s):

Antoine Guillon ◽

C. Hermetet ◽

K. A. Barker ◽

Y. Jouan ◽

C. Gaborit ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Elderly Patients ◽

Healthcare Utilization ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Risk Of Death ◽

Before And After ◽

Frailty Score

Abstract Background: Intensive care unit (ICU) hospitalisations of elderly patients with acute respiratory infection (ARI) have increased, yet the long-term effect of ICU admission among elderly individuals remain unknown. We examined differences over the two years after discharge in mortality, healthcare utilization and frailty score between elderly survivors of ARI in the ICU and an elderly control population.Methods: We used 2009-2017 data from 39 hospital discharge databases. Patients ≥80 years old discharged alive from ICU-hospitalisation for acute respiratory infection were propensity-score matched with controls (cataract surgery) discharged from the hospital at the same time and adjusted for age, sex and comorbidities present before hospitalisation. We reported 2-year mortality and compared healthcare utilization and frailty scores in the 2-year periods before and after ICU-hospitalisation.Results: 1,220 elderly survivors of acute respiratory infection in the ICU were discharged, and 988 were successfully matched with controls. After discharge, patients had a 10.1-fold [95%CI, 6.1-17.3] higher risk of death at 6 months and 3.6-fold [95%CI, 2.9-4.6] higher risk of death at 2 years compared with controls. They also had a 2-fold increase in both healthcare utilization and frailty score in the 2 years after hospital discharge, whereas healthcare utilization and frailty scores among controls were stable before and after hospitalisation.Conclusions: We observed a substantially increased rate of death in the years after ICU-hospitalisation for elderly patients along with elevated healthcare resource use and accelerated age-associated decline as assessed by frailty score. These findings provide data for better informed goals-of-care discussions and may help target post-ICU discharge services.Funding: None

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Long-term survival of elderly patients after intensive care unit admission for acute respiratory infection: a population-based, propensity-score matched cohort study.

10.21203/rs.2.22685/v3 ◽

2020 ◽

Author(s):

Antoine Guillon ◽

C. Hermetet ◽

K. A. Barker ◽

Y. Jouan ◽

C. Gaborit ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Elderly Patients ◽

Healthcare Utilization ◽

Respiratory Infection ◽

Acute Respiratory Infection ◽

Risk Of Death ◽

Before And After ◽

Frailty Score

Abstract Background Intensive care unit (ICU) hospitalisations of elderly patients with acute respiratory infection have increased, yet the long-term effects of ICU admission among elderly individuals remain unknown. We examined differences over the two years after discharge in mortality, healthcare utilization and frailty score between elderly survivors of ARI in the ICU and an elderly control population.Methods We used 2009-2017 data from 39 hospital discharge databases. Patients ≥80 years old discharged alive from ICU-hospitalisation for acute respiratory infection were propensity-score matched with controls (cataract surgery) discharged from the hospital at the same time and adjusted for age, sex and comorbidities present before hospitalisation. We reported 2-year mortality and compared healthcare utilization and frailty scores in the 2-year periods before and after ICU-hospitalisation.Results 1,220 elderly survivors of acute respiratory infection in the ICU were discharged, and 988 were successfully matched with controls. After discharge, patients had a 10.1-fold [95%CI, 6.1-17.3] higher risk of death at 6 months and 3.6-fold [95%CI, 2.9-4.6] higher risk of death at 2 years compared with controls. They also had a 2-fold increase in both healthcare utilization and frailty score in the 2 years after hospital discharge, whereas healthcare utilization and frailty scores among controls were stable before and after hospitalisation.Conclusions We observed a substantially increased rate of death in the years following ICU-hospitalisation for elderly patients along with elevated healthcare resource use and accelerated age-associated decline as assessed by frailty score. These findings provide data for better informed goals-of-care discussions and may help target post-ICU discharge services.Funding: None

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842: Low Efficacy of Intravesical BCG Immunotherapy in Elderly Patients with Intermediate-High Risk Ta-T1 Transitional Cell Carcinoma (TCC) of the Bladder: Long Term Experience of a Single Institution

The Journal of Urology ◽

10.1016/s0022-5347(18)33078-7 ◽

2006 ◽

Vol 175 (4S) ◽

pp. 271-272 ◽

Cited By ~ 1

Author(s):

Giorgio Verrini ◽

Maurizio Brausi ◽

Mirko Gavioli ◽

Giuseppe De Luca ◽

Giancarlo Peracchia ◽

...

Keyword(s):

High Risk ◽

Elderly Patients ◽

Transitional Cell Carcinoma ◽

Cell Carcinoma ◽

Transitional Cell ◽

Single Institution ◽

Bcg Immunotherapy ◽

Intravesical Bcg ◽

Long Term Experience

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Long-term results of Wllstent implantation in benign prostatic hyperplasia and in high-risk groups

Der Urologe ◽

10.1007/s001200050081 ◽

1997 ◽

Vol 36 (2) ◽

pp. 151-156 ◽

Cited By ~ 3

Author(s):

M. Goepel ◽

A. Senge ◽

T. Otto ◽

H. Rübben

Keyword(s):

Benign Prostatic Hyperplasia ◽

High Risk ◽

Risk Groups ◽

Prostatic Hyperplasia ◽

Long Term Results

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Comparison of Outcomes Between McKeown and Sweet Esophagectomy in the Elderly Patients for Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Analysis

Cancer Control ◽

10.1177/1073274820904700 ◽

2020 ◽

Vol 27 (1) ◽

pp. 107327482090470

Author(s):

Dongni Chen ◽

Yihuai Hu ◽

Youfang Chen ◽

Jia Hu ◽

Zhesheng Wen

Keyword(s):

Squamous Cell Carcinoma ◽

Propensity Score ◽

Esophageal Squamous Cell Carcinoma ◽

Elderly Patients ◽

Cell Carcinoma ◽

Squamous Cell ◽

The Elderly ◽

Perioperative Outcomes ◽

Term Survival

The aim of this study was to compare the perioperative outcomes and long-term survival rates of the McKeown and Sweet procedures in patients with esophageal cancer younger than 70 years or older than 70 years. A total of 1432 consecutive patients with esophageal squamous cell carcinoma (ESCC) who received surgery at Sun Yat-sen University Cancer Center from January 2009 to October 2012 were analyzed. Propensity score matching was used to balance the clinical characteristics of the patients who underwent different surgical approaches, and 275 and 71 paired cases were matched among those younger and older than 70 years, respectively. The prognosis and postoperative outcomes were compared between the McKeown and the Sweet esophagectomy. For patients younger than 70 years, those who underwent the McKeown procedure had better overall survival (OS) than those in the Sweet group (log rank = 4.467; P = .035). However, no significant difference in disease-free survival and OS was observed between two approaches for the elderly patients (log rank = 1.562; P = .211 and log rank = 0.668; P = .414, respectively). Cox regression analysis revealed that McKeown approach was a positive prognostic factor compared to the Sweet approach for patients younger than 70 years in univariable analysis (HR = 0.790; 95% CI, 0.625-0.997; P = .047), whereas the surgical approach was not significantly related to the prognosis in the elderly patients. For patients older than 70 years, the occurrence of anastomotic fistula increased in those who underwent the McKeown procedure (23.9% vs 11.3%, P = .038, for the McKeown and Sweet esophagectomy, respectively). The McKeown approach increases the OS in younger patients with ESCC. However, for patients older than 70 years, the Sweet approach was proven to be an effective therapy, given the better perioperative outcomes and similar long-term survival compared with patients in the McKeown group.

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Satisfaction With Informal Volunteering During the COVID-19 Crisis: An Empirical Study Considering a Swiss Online Volunteering Platform

Nonprofit and Voluntary Sector Quarterly ◽

10.1177/0899764020964595 ◽

2020 ◽

Vol 49 (6) ◽

pp. 1142-1151

Author(s):

Stefan Trautwein ◽

Florian Liberatore ◽

Jörg Lindenmeier ◽

Georg von Schnurbein

Keyword(s):

High Risk ◽

Empirical Study ◽

Online Survey ◽

Risk Groups ◽

Empirical Results ◽

Susceptibility To Infection ◽

Informal Volunteering ◽

Volunteer Motives ◽

Online Volunteering

The COVID-19 pandemic has led to a huge wave of compassion. In particular, online volunteering platforms established channeling help for high-risk groups. It is unclear under which conditions volunteers were satisfied with their COVID-19 volunteering mediated by these platforms and whether they will continue their engagement after the crisis. Therefore, and considering personal susceptibility to COVID-19 infection, this study analyzes the effects of different platform support for volunteers and the fulfillment of volunteers’ motives. The study is based on an online survey of a sample of 565 volunteers who registered at and were placed by a Swiss online platform. Fulfillment of distinct volunteer motives and platform support drive COVID-19 volunteering satisfaction. Moreover, motive fulfillment and platform-related support indirectly impact willingness to volunteer long-term via volunteering satisfaction. Finally, the empirical results show that motive fulfillment and the effect of platform support are contingent on perceived susceptibility to infection.

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Late diagnosis of human immunodeficiency virus infections in high-risk groups in Karachi, Pakistan

International Journal of STD & AIDS ◽

10.1177/0956462418785264 ◽

2018 ◽

Vol 29 (14) ◽

pp. 1400-1406

Author(s):

Zahra Hasan ◽

Sharaf Shah ◽

Rumina Hasan ◽

Shoaib Rao ◽

Manzoor Ahmed ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

High Risk ◽

Early Diagnosis ◽

Hiv Infection ◽

Hiv Infections ◽

Risk Groups ◽

Newly Diagnosed ◽

Immunodeficiency Virus ◽

Hiv 1

Human immunodeficiency virus (HIV) infection prevalence in Pakistan has been increasing in high-risk groups, including people who inject drugs (PWID) and transgender hijra sex workers (TG-HSWs) nationwide. Effective control of HIV requires early diagnosis of the infection. We investigated recency of HIV infections in newly-diagnosed cases in PWID and TG-HSWs. This was an observational study with convenience sampling. Overall, 210 HIV-positive subjects comprising an equal number of PWID and TG-HSWs were included. Antibody avidity was tested using the Maxim HIV-1 Limiting Antigen Avidity (LAg) EIA (Maxim Biomedical, Inc. Rockville, Maryland, USA). The mean age of study subjects was 29.5 years: PWID, 28.5 years and TG-HSWs, 30.4 years. Study subjects were married, 27%, or unmarried. Eighteen percent of individuals had recently-acquired HIV infections: 19% of PWID and 17% of TG-HSWs. Eighty-two percent of individuals had long-term HIV infections: 81% of PWID and 83% of TG-HSWs. This is the first study identification of recent HIV-1 infections in Pakistan. We show that most newly-diagnosed HIV patients in the high-risk groups studied had long-term infections. There is an urgent need for intervention in these groups to facilitate early diagnosis and treatment of HIV infection to reduce transmission in Pakistan.

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Contraception and pregnancy

10.1093/med/9780199228188.003.0028 ◽

2011 ◽

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

High Risk ◽

General Population ◽

Congenital Heart ◽

Post Partum ◽

Maternal Risk ◽

Risk Of Death ◽

Pregnancy And Delivery

Introduction 208General principles 208Contraception 210Preconception 214Pregnancy and delivery 218Post-partum 220Heart disease is the largest single cause of maternal death in the UK4. The number and complexity of survivors of congenital heart disease well enough to consider pregnancy is growing. The maternal risk amongst this population varies from being no different to that of the general population, to carrying a high risk of long-term morbidity and >40% risk of death....

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