Clustering analysis of geriatric and acute characteristics in a cohort of very old patients on admission to ICU.
Intensive Care Med
; 48(12): 1726-1735, 2022 Dec.
Статья
в английский
| MEDLINE | ID: covidwho-2158015
ABSTRACT
PURPOSE:
The biological and functional heterogeneity in very old patients constitutes a major challenge to prognostication and patient management in intensive care units (ICUs). In addition to the characteristics of acute diseases, geriatric conditions such as frailty, multimorbidity, cognitive impairment and functional disabilities were shown to influence outcome in that population. The goal of this study was to identify new and robust phenotypes based on the combination of these features to facilitate early outcome prediction.METHODS:
Patients aged 80 years old or older with and without limitations of life-sustaining treatment and with complete data were recruited from the VIP2 study for phenotyping and from the COVIP study for external validation. The sequential organ failure assessment (SOFA) score and its sub-scores taken on admission to ICU as well as demographic and geriatric patient characteristics were subjected to clustering analysis. Phenotypes were identified after repeated bootstrapping and clustering runs.RESULTS:
In patients from the VIP2 study without limitations of life-sustaining treatment (n = 1977), ICU mortality was 12% and 30-day mortality 19%. Seven phenotypes with distinct profiles of acute and geriatric characteristics were identified in that cohort. Phenotype-specific mortality within 30 days ranged from 3 to 57%. Among the patients assigned to a phenotype with pronounced geriatric features and high SOFA scores, 50% died in ICU and 57% within 30 days. Mortality differences between phenotypes were confirmed in the COVIP study cohort (n = 280).CONCLUSIONS:
Phenotyping of very old patients on admission to ICU revealed new phenotypes with different mortality and potential need for anticipatory intervention.ключевые слова
Полный текст:
Имеется в наличии
Коллекция:
Международные базы данных
база данных:
MEDLINE
Основная тема:
Frailty
/
Intensive Care Units
Тип исследования:
Когортное исследование
/
Диагностическое исследование
/
Наблюдательное исследование
/
Прогностическое исследование
Пределы темы:
Люди
Язык:
английский
Журнал:
Intensive Care Med
Год:
2022
Тип:
Статья
Аффилированная страна:
S00134-022-06868-x
Документы, близкие по теме
MEDLINE
...
LILACS
LIS