scholarly journals Intensive care–treated cardiac arrest: a retrospective study on the impact of extended age on mortality, neurological outcome, received treatments and healthcare-associated costs

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Ester Holmström ◽  
Ilmar Efendijev ◽  
Rahul Raj ◽  
Pirkka T. Pekkarinen ◽  
Erik Litonius ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
Retrospective Study ◽  
Cost Effectiveness ◽  
Neurological Outcome ◽  
Age Groups ◽  
The Elderly ◽  
Treatment Intensity ◽  
One Year ◽  
Healthcare Associated

Abstract Background Cardiac arrest (CA) is a leading cause of death worldwide. As population ages, the need for research focusing on CA in elderly increases. This study investigated treatment intensity, 12-month neurological outcome, mortality and healthcare-associated costs for patients aged over 75 years treated for CA in an intensive care unit (ICU) of a tertiary hospital. Methods This single-centre retrospective study included adult CA patients treated in a Finnish tertiary hospital’s ICU between 2005 and 2013. We stratified the study population into two age groups: <75 and $$\ge$$ ≥ 75 years. We compared interventions defined by the median daily therapeutic scoring system (TISS-76) between the age groups to find differences in treatment intensity. We calculated cost-effectiveness by dividing the total one-year healthcare-associated costs of all patients by the number of survivors with a favourable neurological outcome. Favourable outcome was defined as a cerebral performance category (CPC) of 1–2 at 12 months after cardiac arrest. Logistic regression analysis was used to identify independent associations between age group, mortality and neurological outcome. Results This study included a total of 1,285 patients, of which 212 (16 %) were $$\ge$$ ≥ 75 years of age. Treatment intensity was lower for the elderly compared to the younger group, with median TISS scores of 116 and 147, respectively (p < 0.001). The effective cost in euros for patients with a good one-year neurological outcome was €168,000 for the elderly and €120,000 for the younger group. At 12 months after CA 24 % of the patients in the elderly group and 47 % of the patients in the younger group had a CPC of 1–2 (p < 0.001). Age was an independent predictor of mortality (multivariate OR = 2.90, 95 % CI: 1.94–4.31, p < 0.001) and neurological outcome (multivariate OR = 3.15, 95 % CI: 2.04–4.86, p < 0.001). Conclusions The elderly ICU-treated CA patients in this study had worse neurological outcomes, higher mortality and lower cost-effectiveness than younger patients. Elderly received less intense treatment. Further efforts are needed to recognize the tools for assessing which elderly patients benefit from a more aggressive treatment approach in order to improve the cost-effectiveness of post-CA management.

scholarly journals Intensive care–treated cardiac arrest: A retrospective study on the impact of extended age on mortality, neurological outcome, received treatments and healthcare-associated costs

2021 ◽  
Author(s):  
Ester Elisabet Holmström ◽  
Ilmar Efendijev ◽  
Rahul Raj ◽  
Pirkka T. Pekkarinen ◽  
Erik Litonius ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
Retrospective Study ◽  
Cost Effectiveness ◽  
Neurological Outcome ◽  
Age Groups ◽  
The Elderly ◽  
Treatment Intensity ◽  
One Year ◽  
Healthcare Associated

Abstract Background: Cardiac arrest (CA) is a leading cause of death worldwide. As population ages, the need for research focusing on CA in elderly increases. This study investigated treatment intensity, 12-month neurological outcome, mortality and healthcare-associated costs for patients aged over 75 years treated for CA in an intensive care unit (ICU) of a tertiary hospital. Methods: This single-centre retrospective study included adult CA patients treated in a Finnish tertiary hospital’s ICU between 2005 and 2013. We stratified the study population into two age groups: <75 and 75 years. We compared interventions defined by the median daily therapeutic scoring system (TISS-76) between the age groups to find differences in treatment intensity. We calculated cost-effectiveness by dividing the total one-year healthcare-associated costs of all patients by the number of survivors with a favourable neurological outcome. Favourable outcome was defined as a cerebral performance category (CPC) of 1–2 at 12 months after cardiac arrest. Logistic regression analysis was used to identify independent association between age group, mortality and neurological outcome. Results: This study included a total of 1,285 patients, of which 212 (16%) were 75 years of age. Treatment intensity was lower for the elderly compared to the younger group, with median TISS scores of 116 and 147, respectively (p < 0.001). The effective cost in euros for patients with a good one-year neurological outcome was €168,000 for the elderly and €120,000 for the younger group. At 12 months after CA 24% of the patients in the elderly group and 47% of the patients in the younger group had a CPC of 1-2 (p < 0.001). Age was an independent predictor of mortality (multivariate OR = 3.36, 95% CI:2.21-5.11, p < 0.001) and neurological outcome (multivariate OR = 3.27, 95% CI: 2.12-5.03, p < 0.001). Conclusions: The elderly ICU-treated CA patients in this study had worse neurological outcomes, higher mortality and lower cost-effectiveness than younger patients. Further efforts are needed to recognize the tools for assessing which elderly patients benefit from a more aggressive treatment approach in order to improve the cost-effectiveness of post-CA management.

scholarly journals Outcomes and healthcare-associated costs one year after intensive care-treated cardiac arrest

Resuscitation ◽  
2018 ◽  
Vol 131 ◽  
pp. 128-134 ◽  
Author(s):  
Ilmar Efendijev ◽  
Daniel Folger ◽  
Rahul Raj ◽  
Matti Reinikainen ◽  
Pirkka T. Pekkarinen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
One Year ◽  
Healthcare Associated

One-year mortality of patients admitted to the intensive care unit after in-hospital cardiac arrest: a retrospective study

2018 ◽  
Vol 48 ◽  
pp. 345-351 ◽  
Author(s):  
Marc Schluep ◽  
Saskia Rijkenberg ◽  
Robert Jan Stolker ◽  
Sanne Hoeks ◽  
Henrik Endeman
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Retrospective Study ◽  
One Year ◽  
Hospital Cardiac Arrest

scholarly journals Corrigendum to “Outcomes and healthcare-associated costs one year after intensive care-treated cardiac arrest” [Resuscitation 131 (2018) 128–134]

Resuscitation ◽  
2018 ◽  
Vol 133 ◽  
pp. 193 ◽  
Author(s):  
Ilmar Efendijev ◽  
Daniel Folger ◽  
Rahul Raj ◽  
Matti Reinikainen ◽  
Pirkka T. Pekkarinen ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
One Year ◽  
Healthcare Associated

scholarly journals Ten-year survival of Finnish lower limb amputees

1998 ◽  
Vol 22 (1) ◽  
pp. 10-16 ◽  
Author(s):  
T. Pohjolainen ◽  
H. Alaranta
Keyword(s):  
Median Survival ◽  
Lower Limb ◽  
Social Insurance ◽  
Age Groups ◽  
Vascular Diseases ◽  
The Elderly ◽  
Limb Amputation ◽  
Diabetic Patients ◽  
Trauma Patients ◽  
One Year

Data on mortality for the ten years following lower limb amputation were obtained from all the 16 surgical units in Southern Finland and the National Social Insurance Institution. In Southern Finland during the period 1984-1985, amputations of the lower limb were performed on 705 patients, of whom 382 (54%) were women and 323 (46%) men. The majority of the amputations, 47%, were performed for vascular diseases and 41% were performed for diabetes mellitus. The overall survival was 62% at one year after amputation, 49% at two years, 27% at five years and 15% at ten years. The median survival after amputation was 1 yr 5 mth for the women and 2 yr 8 mth for the men. Of the arteriosclerotics, 43% died within one postoperative year while 43% lived longer than two years and 23% longer than five years. The median survival of arteriosclerotics was 1 yr 6 mth. The corresponding figure for patients with diabetes was 1 yr 11 mth. Of the diabetics, 38% died within one postoperative year while 47% lived longer than two years and 20% longer than five years. Of the trauma patients, 86% lived longer than five years and 71% longer than ten years. Of the trans-femoral amputees, 54% lived longer than one year, 36% over two years, 18% over five years and 8% over ten years. The corresponding figures for trans-tibial amputees were 70%. 53%, 21% and 4%. Many elderly vascular and diabetic patients undergoing amputation have a reduced physiological reserve and high mortality. The more proximal the amputation, the greater the risk that the patient will never be able to walk or that the duration of use of the prosthesis will be short. If a prosthesis seems to be a reasonable option for the elderly amputee, any delays in prosthetic fitting should be avoided in older age groups.

scholarly journals Human Sapovirus among Outpatients with Acute Gastroenteritis in Spain: A One-Year Study

Viruses ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 144 ◽  
Author(s):  
Miguel F Varela ◽  
Enrique Rivadulla ◽  
Alberto Lema ◽  
Jesús L Romalde
Keyword(s):  
Acute Gastroenteritis ◽  
Age Groups ◽  
The Elderly ◽  
Mean Value ◽  
Early Spring ◽  
Clinical Samples ◽  
Late Winter ◽  
Viral Pathogen ◽  
One Year ◽  
Different Strains

Viral agents of human gastroenteritis affect people of all ages across the globe. As a mainly self-limiting disease, it is difficult to evaluate the real prevalence of etiological agents circulating in each region. Many of the analyzed outbreaks are caused by viruses of the family Caliciviridae, especially the genus Norovirus (NoV). Most studies have focused on other enteric viruses, leaving sapovirus (SaV) underestimated as an important emerging human threat. This one-year study analyzed clinical samples from hospital outpatients with acute gastroenteritis in Spain, with the aim of revealing the importance of human SaV as an emerging viral pathogen. A total of 2667 stools were tested using reverse transcription (RT)-qPCR to detect and quantify SaV. Sapovirus was detected in all age groups, especially in infants, children, and the elderly. The prevalence was 15.64% (417/2667), and was slightly higher in 0–2- and 3–5-year-olds (19.53% and 17.95%, respectively) and much lower in 13–18-year-olds (9.86%). Positive samples were detected throughout the year, with peaks of detection during autumn and the late winter to early spring months. The mean value for the quantified samples was 6.5 × 105 genome copies per gram of stool (GC/g) (range 2.4 × 103–6.6 × 1011 GC/g). RT-nested PCR and sequencing were used for further genotyping. Genetic characterization showed a predominance of genogroup I (GI), followed by GII and GIV. The detection of multiple genotypes suggests the circulation of different strains without any clear tendency. The results obtained suggest SaV as the second major gastroenteritis agent after NoV in the region.

Lower cost-effectiveness for intensive care-treated elderly after cardiac arrest

Resuscitation ◽  
2019 ◽  
Vol 142 ◽  
pp. e22-e23
Author(s):  
Ester Holmström ◽  
Ilmar Efendijev ◽  
Rahul Raj ◽  
Pirkka Pekkarinen ◽  
Erik Litonius ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Lower Cost

scholarly journals Comparison of inconclusive rates between suction rectal biopsy and open strip rectal biopsy in children of different age groups: a single-center retrospective study

2020 ◽  
Vol 3 (1) ◽  
pp. e000080
Author(s):  
Cedric Ian Ng Liet Hing ◽  
Roy Teng ◽  
Liesel Porrett ◽  
Richard Thompson
Keyword(s):  
Retrospective Study ◽  
Fibrous Tissue ◽  
Age Groups ◽  
Rectal Biopsy ◽  
Single Center ◽  
Older Children ◽  
Suction Rectal Biopsy ◽  
Significant Difference ◽  
Pull Through ◽  
One Year

BackgroundRectal biopsy for the diagnosis for Hirschsprung's disease (HD) can be performed in several ways. Suction rectal biopsy (SRB) is the most widely used method for neonates and younger infants while open strip biopsy (OSB) is reserved for older children. Current notions suggest that SRB should not be used in older infants due to perceived thicker fibrous tissue in their rectal walls leading to higher rates of inconclusive results. This study aims to compare the inconclusive rates of both methods in children of different age groups.MethodsA retrospective study were carried out with patients aged 13 years who underwent SRB or OSB during a 4-year period in a single center. Rectal biopsies were performed on patients with HD with previous endorectal pull-through surgeries excluded. Primary outcomes were rates of inconclusive results for SRB and OSB overall and when divided into different age groups.Results79 biopsies (57 SRB and 22 OSB) were included in the study. 12 biopsies (9 SRB and 3 OSB) were deemed inconclusive. There was no significant difference in the rate of inconclusive results between patients underwent SRB and OSB overall (15.8% vs 13.6%, p=1.000). The same results were obtained when patients were divided into under one year and over one year groups or other different age groups (30.0% vs 33.3%, p=1.000).ConclusionsDespite low biopsy numbers, our study suggests that SRB provides comparable rates of inconclusive results with OSB in children of all age groups.

Factors Associated with Survival and Neurological Outcome after Cardiopulmonary Resuscitation of Neurosurgical Intensive Care Unit Patients

Neurosurgery ◽  
2006 ◽  
Vol 59 (4) ◽  
pp. 838-846 ◽  
Author(s):  
Hyeong-Joong Yi ◽  
Young-Soo Kim ◽  
Yong Ko ◽  
Suck-Jun Oh ◽  
Kwang-Myung Kim ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Factors Associated ◽  
Neurosurgical Patients ◽  
Neurosurgical Intensive Care ◽  
Vestibular Reflex ◽  
Neurosurgical Intensive Care Unit

Abstract OBJECTIVE: We investigated predictors of survival and the neurological outcomes of neurosurgical patients who experienced cardiac arrest and received cardiopulmonary resuscitation after being admitted to the neurosurgical intensive care unit. METHODS: A retrospective study was conducted of adult patients in the neurosurgical intensive care unit who had experienced cardiac arrest and received cardiopulmonary resuscitation. Factors relevant to the cardiac arrest (before and after arrest) were used to study association with survival (immediate or short-term) and neurological outcome (unconscious or conscious) via statistical methods. RESULTS: Immediate survival was seen in 105 patients (49%), 19 survived until hospital discharge, and 11 were still alive at the conclusion of this study. Of the immediate survivors, 41 patients were conscious and 64 were unconscious. Multivariate analysis showed increased mortality in patients with infection, asystole, or resuscitation time exceeding 30 minutes (P &lt; 0.05). Additional factors associated with high in-hospital mortality included lack of spontaneous respiration, no caloric-vestibular reflex, and unconsciousness after resuscitation (P &lt; 0.05). In addition, neurological recovery was poor in patients with infection, asystole, no caloric-vestibular reflex, conscious recovery, or resuscitation lasting more than 30 minutes (P &lt; 0.05). CONCLUSION: Even after initially successful resuscitation, survival and neurological recovery is quite dismal in patients with cerebral lesions. Prognostic factors for neurosurgical patients should be assessed on an individual basis to determine medical futility in the early post-resuscitation period.

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