[Mortality in patients with dementia admitted in critical care units]. / Mortalidad en pacientes con demencia que cursaron internación en unidades de cuidados críticos.

OBJECTIVE: To determine the mortality and comorbidities associated of patients with dementia admitted to the Intensive Care Unit (ICU) on the hospitalization and at one year of follow-up. MATERIALS AND METHODS: A retrospective observational cohort study was carried out between 2012 and 2017 at the Hospital Italiano de San Justo, of patients who were admitted to the ICU, these were observed up to hospitalary death, out hospital death one year of hospitalization, the disenrollment from the institution's health plan or the end of the follow-up. RESULTS: A total of 163 patients were included for analysis. We recorded those 79 patients (48.47%) died one year after the hospitalization, of them 25 (15.34%) in ICU and 8 (4.91%) in general room. The most frequent causes of death were respiratory. The factors most associated with mortality were: orotracheal intubation (HR=2.01; 95% CI: 1.11-3.65; P=.02), history of leukemia (HR=8.55; 95% CI: 1.82-40.05; P≤.05), elevated Charlson (HR=1.16, 95% CI: 1.04-1.41; P=.05), and elevated APACHE II at admission (HR=1.07; 95% CI: 1.03-1.11; P≤.05). CONCLUSIONS: The present study expresses the prognosis of patients with a diagnosis of dementia admitted to the ICU and that depends not only on their baseline neurological status but also on the severity at admission and comorbidities.

Mortalidad en pacientes con demencia que cursaron internación en unidades de cuidados críticos / Mortality in patients with dementia admitted in critical care units

Objetivo: Determinar la morbimortalidad asociada de los pacientes con demencia internados en la Unidad de Cuidados Intensivos (UCI) durante el período de hospitalización y al año de seguimiento.Materiales y métodos: Se realizó un estudio de cohorte retrospectiva entre los años 2012 y 2017 en el Hospital Italiano de San Justo, de pacientes con diagnóstico previo de demencia que cursaron internación en la UCI; estos fueron observados hasta la muerte intrahospitalaria, la muerte extrahospitalaria al año de internación índice, la desafiliación del plan prepago de la institución o el final del seguimiento.Resultados: Se incluyeron 163 pacientes para el análisis. Se registró que 79 pacientes (48,47%) fallecieron al año de la internación índice; de ellos, 25 (15,34%) en UCI y 8 (4,91%) en sala general. Las causas más frecuentes de muerte fueron de índole respiratoria. Los factores que más se asociaron a mortalidad fueron: intubación orotraqueal (HR = 2,01; IC95%: 1,11-3,65; p = 0,02), antecedente de leucemia (HR = 8,55; IC95%: 1,82-40,05; p ≤ 0,05), Charlson elevado (HR = 1,16, IC95%: 1,04-1,41; p = 0,05) y APACHE II elevado al ingreso (HR = 1,07; IC95%: 1,03-1,11; p ≤ 0,05).Conclusiones: El presente estudio expone el pronóstico desfavorable de los pacientes con diagnóstico de demencia ingresados en UCI y que además el mismo depende no solo de su estado neurológico basal, sino también de la gravedad al ingreso y de las comorbilidades asociadas. (AU)

Objective: To determine the mortality and comorbidities associated of patients with dementia admitted to the Intensive Care Unit (ICU) on the hospitalization and at one year of follow-up.Materials and methods: A retrospective observational cohort study was carried out between 2012 and 2017 at the Hospital Italiano de San Justo, of patients who were admitted to the ICU, these were observed up to hospitalary death, out hospital death one year of hospitalization, the disenrollment from the institution's health plan or the end of the follow-up.Results: A total of 163 patients were included for analysis. We recorded those 79 patients (48.47%) died one year after the hospitalization, of them 25 (15.34%) in ICU and 8 (4.91%) in general room. The most frequent causes of death were respiratory. The factors most associated with mortality were: orotracheal intubation (HR=2.01; 95% CI: 1.11-3.65; P=.02), history of leukemia (HR=8.55; 95% CI: 1.82-40.05; P≤.05), elevated Charlson (HR=1.16, 95% CI: 1.04-1.41; P=.05), and elevated APACHE II at admission (HR=1.07; 95% CI: 1.03-1.11; P≤.05).Conclusions: The present study expresses the prognosis of patients with a diagnosis of dementia admitted to the ICU and that depends not only on their baseline neurological status but also on the severity at admission and comorbidities. (AU)