Short- and long-term outcomes of older patients in intermediate care units

Olga H. Torres, Esther Francia, Vanesa Longobardi, Ignasi Gich, Salvador Benito, Domingo Ruiz

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52 Citations (Scopus)

Abstract

Objective: To evaluate short- and long-term outcomes of elderly patients (≥ 65 years) treated at an intermediate care unit (IMCU) and to identify outcome predictors. Design and setting: Prospective observational study in the IMCU of a university teaching hospital. Participants: We studied 412 patients over 8 months, classified into three groups: under 65 years (control group, n = 158), 65-80 (n = 186), and > 80 (n = 68). Measurements: At admission: APACHE II, TISS-28 first day, Charlson Index, diagnosis, and prior Barthel Index. Outcome measures: in-hospital mortality, length of stay, discharge destination, and 2-year mortality and readmissions. Data analysis included multivariate logistic regression and receiver operating characteristics area under the curve (ROC AUC). Results: No statistically significant differences between groups were observed in hospital mortality (14.1%), discharge to a long-term facility (2.7%), or 2-year readmissions (1.2 ± 2.1). However, hospital stay was longer in patients aged 65-80 years (14 vs.10 days) and 2-year mortality was higher in those 65 or over (34% vs.10.6%). In the overall series in-hospital mortality was predicted by APACHE II, first-day TISS-28, and diagnosis (ROC AUC 0.81), and 2-year mortality by Charlson Index and age (ROC AUC 0.77). In the elderly patients 2-year mortality was predicted by Charlson and Barthel indices (ROC AUC 0.70). Conclusions: Illness severity and therapeutic intervention at admission to IMCU were predictors of short-term mortality, whereas the strongest predictor of long-term mortality was comorbidity. Our results suggest that comprehensive assessment of elderly patients at admission to IMCUs may improve outcome prediction. © Springer-Verlag 2006.
Original languageEnglish
Pages (from-to)1052-1059
JournalIntensive Care Medicine
Volume32
Issue number7
DOIs
Publication statusPublished - 1 Jul 2006

Keywords

  • Aged
  • Aged, 80 years and over
  • High-dependency unit
  • Prognosis
  • Prospective studies

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