Clinical evolution of adult, elderly and very elderly patients admitted in Intensive Care Units

Abstract Background The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in Rome. Methods This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65–80 years old; Very Elderly > 80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH) s and clinical outcomes. Results We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease. Conclusion We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.

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A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0005270 ◽

2017 ◽

Vol 11 (1) ◽

pp. e0005270 ◽

Cited By ~ 14

Author(s):

Chih-Cheng Hsieh ◽

Cong-Tat Cia ◽

Jen-Chieh Lee ◽

Junne-Ming Sung ◽

Nan-Yao Lee ◽

...

Keyword(s):

Cohort Study ◽

Intensive Care ◽

Intensive Care Units ◽

The Elderly ◽

Adult Patients ◽

Severe Dengue

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500: THE COST TO ACHIEVE FUNCTIONAL RECOVERY IN VERY ELDERLY PATIENTS ADMITTED TO INTENSIVE CARE UNITS

Critical Care Medicine ◽

10.1097/01.ccm.0000528518.33388.5e ◽

2018 ◽

Vol 46 (1) ◽

pp. 235-235

Author(s):

Nicolas Chin-Yee ◽

Gianni D’Egidio ◽

Kednapa Thavorn ◽

Sasha Van Katwyk ◽

Daren Heyland ◽

...

Keyword(s):

Intensive Care ◽

Elderly Patients ◽

Intensive Care Units ◽

Functional Recovery ◽

Very Elderly ◽

The Cost

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P-479: Awareness and decision-making to advance directives among the elderly patients admitted at intensive care units in middle Taiwan

European Geriatric Medicine ◽

10.1016/s1878-7649(15)30603-3 ◽

2015 ◽

Vol 6 ◽

pp. S184-S185 ◽

Cited By ~ 1

Author(s):

C.-M. Chang ◽

H.-C. Lin ◽

C.-L. Lee

Keyword(s):

Decision Making ◽

Intensive Care ◽

Elderly Patients ◽

Intensive Care Units ◽

Advance Directives ◽

The Elderly

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Intensive Care Units: The Clinical Pharmacist Role to Improve Clinical Outcomes and Reducing Mortality Rate. An Undeniable Function

Journal of Pharmaceutical and Pharmacological Sciences ◽

10.29011/2574-7711.100044 ◽

2017 ◽

Vol 2 (4) ◽

Author(s):

Mauro Luisetto

Keyword(s):

Intensive Care ◽

Mortality Rate ◽

Clinical Outcomes ◽

Intensive Care Units ◽

Clinical Pharmacist ◽

Pharmacist Role

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Predictors of nursing workload in elderly patients admitted to intensive care units

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692008000200008 ◽

2008 ◽

Vol 16 (2) ◽

pp. 218-223 ◽

Cited By ~ 15

Author(s):

Cleber Ricardo de Sousa ◽

Leilane Andrade Gonçalves ◽

Maria Cecília Toffoleto ◽

Karine Leão ◽

Kátia Grillo Padilha

Keyword(s):

Intensive Care ◽

Elderly Patients ◽

The Elderly ◽

Simplified Acute Physiology Score ◽

Cross Sectional Study ◽

Nursing Workload ◽

Cross Sectional ◽

Significant Difference ◽

Surgical Icu ◽

Independent Risk Factors

The age of patients is a controversial issue in admission to intensive care unit (ICU). The aim of this study was to compare severity and nursing workload of elderly patients with 60-69, 70-79, and e"80 years of age and to identify predictors of nursing workload in elderly patients. A cross sectional study was performed with a sample of 71 elderly patients admitted to three ICU in the city of Sao Paulo, Brazil from October to November 2004. Data were prospectively collected using Nursing Activities Score (NAS) and Simplified Acute Physiology Score II (SAPS II). There was no significant difference in nursing workload among the elderly patients age subgroups (p=0.84). Multiple regression analysis indicated that the independent risk factors of high nursing workload were severity, age e"70 years, and to be a surgical ICU patient. Age as an isolated factor should not be discriminative for elderly patients admission to ICU.

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Intensive Care Units: The Clinical Pharmacist Role to Improve Clinical Outcomes and Reducing Mortality Rate an Undeniable Function

Modern Approaches in Drug Designing ◽

10.31031/madd.2017.01.000507 ◽

2017 ◽

Vol 1 (2) ◽

Author(s):

Luisetto M

Keyword(s):

Intensive Care ◽

Mortality Rate ◽

Clinical Outcomes ◽

Intensive Care Units ◽

Clinical Pharmacist ◽

Pharmacist Role

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Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes.

10.21203/rs.3.rs-42681/v2 ◽

2020 ◽

Author(s):

Michela D'Ascanio ◽

Marta Innammorato ◽

Lara Pasquariello ◽

Dario Pizzirusso ◽

Giulio Guerrieri ◽

...

Keyword(s):

Mortality Rate ◽

Elderly Patients ◽

Clinical Outcomes ◽

Residential Care ◽

Pneumonia Severity Index ◽

Care Homes ◽

Categorical Variables ◽

Rank Test ◽

Very Elderly ◽

Arterial Blood

Abstract Background: The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in RomeMethods: This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65-80 years old; Very Elderly >80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH)s and clinical outcomes. Results: We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease. Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.

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Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes.

10.21203/rs.3.rs-42681/v3 ◽

2021 ◽

Author(s):

Michela D'Ascanio ◽

Marta Innammorato ◽

Lara Pasquariello ◽

Dario Pizzirusso ◽

Giulio Guerrieri ◽

...

Keyword(s):

Mortality Rate ◽

Elderly Patients ◽

Clinical Outcomes ◽

Residential Care ◽

Pneumonia Severity Index ◽

Care Homes ◽

Categorical Variables ◽

Rank Test ◽

Very Elderly ◽

Arterial Blood

Abstract Background: The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in RomeMethods: This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65-80 years old; Very Elderly >80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH)s and clinical outcomes. Results: We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease. Conclusion: We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.

Download Full-text