Intensive care admission and hospital mortality in the elderly after non-cardiac surgery / Ingreso en cuidados intensivos y mortalidad hospitalaria en pacientes de edad avanzada tras cirugía no cardiaca
Med. intensiva (Madr., Ed. impr.)
; 42(8): 463-472, nov. 2018. tab, graf
Artigo
em Inglês
| IBECS
| ID: ibc-180518
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
OBJECTIVE:
To assess whether patient age is independently associated to Intensive Care Unit (ICU) admission after non-cardiac surgery.DESIGN:
An observational cohort study of the Spanish subset of the European Surgical Outcome Study (EuSOS) was carried out.SETTING:
Hospitals of the public National Health Care System and private hospitals in Spain. Intervention None. PATIENTS ANDMETHODS:
All patients over 16 years of age undergoing inpatient non-cardiac surgery in the participating hospitals during a 7-day period in the month of April 2011 were consecutively included. Main variables of interest ICU admission rate, factors associated with ICU admission and hospital mortality were assessed using logistic regression analysis and fractional polynomial regression.RESULTS:
Out of 5412 patients, 677 (12.5%) were admitted to the ICU after surgery. The adjusted odds ratio (95% confidence interval [CI]) for ICU admission was 1.1 (0.8-1.4) for patients aged 65-74 years, 0.7 (0.5-1) for patients aged 75-85 years, and 0.4 (0.2-0.8) for patients over 85 years, respectively. Age, ASA score, grade of surgery (minor, intermediate, major), urgent surgery, surgical specialty, laparoscopic surgery and metastatic disease were independent factors for ICU admission. Global risk-adjusted mortality was 1.4 (95% CI 0.9-2.2). The ASA score, urgent surgery, surgical specialty and diabetes were predictors of hospital mortality.CONCLUSIONS:
Elderly patients (over 80 years) appear less likely to be admitted to ICU after non-cardiac surgery in Spanish hospitals. There was no significant association between age and postoperative mortality in this cohortRESUMEN
OBJETIVO:
Evaluar si la edad del paciente se asociaba independientemente con el ingreso en la unidad de cuidados intensivos (UCI) tras cirugía no cardiaca.DISEÑO:
Estudio observacional de cohortes del subgrupo español del European Surgical Outcome Study (EuSOS). Ámbito Hospitales públicos y privados en España. Intervención Ninguna. PACIENTES YMÉTODOS:
Pacientes consecutivos mayores de 16 años sometidos a cirugía no cardiaca con ingreso durante un periodo de 7 días del mes de abril de 2011. Variables de interés principal Tasa de ingreso en la UCI, factores asociados con ingreso en la UCI y mortalidad hospitalaria, analizadas mediante regresión logística y regresión fraccional polinómica.RESULTADOS:
De 5.412 pacientes, 677 (12,5%) fueron ingresados en la UCI tras la cirugía. La odds ratio ajustada (intervalo de confianza [IC] del 95%) de ingreso en la UCI fue de 1,1 (0,8-1,4) para 65-74 años, 0,7 (0,5-1) para 75-85 años y de 0,4 (0,2-0,8) para más de 85 años, respectivamente. La edad, el grado ASA, el grado de la cirugía (menor, intermedia, mayor), la cirugía urgente, la especialidad quirúrgica, la cirugía laparoscópica y la enfermedad metastásica fueron factores independientes de ingreso en la UCI. El riesgo global ajustado de mortalidad fue de 1,4 (IC 95% 0,9-2,2). El grado ASA, cirugía urgente, especialidad quirúrgica y diabetes fueron predictores de mortalidad hospitalaria.CONCLUSIONES:
En los hospitales españoles, los pacientes ancianos (más de 80 años) son menos propensos a ser ingresados en la UCI tras cirugía no cardiaca. En esta cohorte, la edad y la mortalidad hospitalaria no se asociaron significativamente
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Base de dados:
IBECS
Assunto principal:
Admissão do Paciente
/
Complicações Pós-Operatórias
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Fatores Etários
/
Mortalidade Hospitalar
/
Unidades de Terapia Intensiva
Limite:
Adulto
/
Idoso
/
Humanos
Idioma:
Inglês
Revista:
Med. intensiva (Madr., Ed. impr.)
Ano de publicação:
2018
Tipo de documento:
Artigo
Instituição/País de afiliação:
Hospital Universitario Río Hortega/Spain
/
Queen Mary University of London/UK
/
Universidad Complutense/Spain
/
Universitat Autònoma de Barcelona/Spain
/
Vall d'Hebron Research Institute/Spain