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Eur J Intern Med ; 26(1): 49-55, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25582073

RESUMEN

PURPOSE: Data are demonstrating the increase in utilization of critical care by the elderly. Around 11% of ICU patients are ≥80years-old. METHODS: An observational retrospective study was conducted between 2003 and 2011, including elderly patients (≥80years old) admitted from medical services to the intensive care unit (ICU) in a tertiary university hospital. The final sample size was N=202. RESULTS: Mortality rates were: ICU 34.1%, in-hospital 44% and 1-year cumulative mortality 55.4% (20.4% for hospital survivors). Multivariate analysis showed that APACHE II score: OR 1.10, 95% CI (1.03-1.18), SAPS II score: OR 1.03, 95% CI (1.01-1.06), a score <3 on the Cruz Roja Hospital mental scale: 0.51 OR, 95% CI (0.01-0.57) and ICU admission for cardiovascular disease: OR 5.05, 95% CI (1.98-12.84) were independently associated with mortality ICU. Factors independently associated with 1-year mortality were: dyslipidemia OR 7.25 (1.47-35.60), chronic kidney failure OR 13.23, 95% CI (2.28-76.6), stroke OR 10.44, 95% CI (2.26-48.25) and antihypertensive treatment OR 0.08, 95% CI (0.01-0.48). In multiple linear regression, ICU length of stay was associated with mechanical ventilation B coefficient 6.41, 95% CI (1.18-11.64) and in-hospital length of stay was related to age: B coefficient -2.17, 95% CI (-4.02 to -0.33). CONCLUSIONS: Prevalence of cardiovascular risk factors and cardiovascular disease was high, and basal cardiovascular treatment was underused. Primary diagnosis for cardiovascular disease at ICU admission should be assessed as predictor of ICU mortality. Intensifying cardiovascular basal treatment could decrease 1-year mortality. Cardiovascular profile did not show an effect on in-hospital mortality and length of stay.


Asunto(s)
Enfermedades Cardiovasculares/mortalidad , Mortalidad Hospitalaria , Tiempo de Internación/estadística & datos numéricos , APACHE , Anciano de 80 o más Años , Antihipertensivos/uso terapéutico , Enfermedades Cardiovasculares/tratamiento farmacológico , Enfermedades Cardiovasculares/epidemiología , Enfermedad Crítica/epidemiología , Enfermedad Crítica/mortalidad , Dislipidemias/epidemiología , Femenino , Hospitales Universitarios , Humanos , Unidades de Cuidados Intensivos , Modelos Lineales , Masculino , Análisis Multivariante , Prevalencia , Insuficiencia Renal Crónica/epidemiología , Estudios Retrospectivos , Accidente Cerebrovascular/epidemiología
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