Trends in short-term and 1-year mortality in very elderly intensive care patients in the Netherlands: a retrospective study from 2008 to 2014
Purpose To describe the trends in short-term and long-term mortality in very elderly intensive care unit (ICU) patients between 2008 and 2014. Methods A retrospective cohort study was conducted using data from the National Intensive Care Evaluation Foundation from 31 Dutch ICUs. Generalized linear m...
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| Veröffentlicht in: | Intensive care medicine 2017-10, Vol.43 (10), p.1476-1484 |
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| creator | Karakus, Attila Haas, Lenneke E. M. Brinkman, Sylvia de Lange, Dylan W. de Keizer, Nicolette F. |
| description | Purpose
To describe the trends in short-term and long-term mortality in very elderly intensive care unit (ICU) patients between 2008 and 2014.
Methods
A retrospective cohort study was conducted using data from the National Intensive Care Evaluation Foundation from 31 Dutch ICUs. Generalized linear mixed-effects models were used to determine the change in adjusted short-term mortality (ICU/hospital deaths) and long-term mortality (3, 6, and 12 months after ICU admission) over the period 2008–2014 in very elderly patients and in patients less than 80 years old admitted to the ICU.
Results
A total of 216,196 patients admitted to 31 ICUs in the period from 2008 to 2014 were included in the study, including 28,284 (13.1%) very elderly patients (80 years or older). Follow-up data for determination of 3-, 6-, and 12-month mortality were available for, respectively, 210,005 (97.1%), 202,551 (93.7%), and 176,847 (81.8%) ICU admissions. The crude ICU and in-hospital mortality decreased, respectively, from 17.6% to 13.0% and from 30.7% to 21.0%. The annual risk-adjusted ICU and in-hospital mortality of very elderly patients (adjusted for APACHE III score, comorbidities, and admission type) decreased significantly during the study period [adjusted odds ratio 0.97 (0.95–0.99) and 0.92 (0.91–0.93), respectively]. Additionally, the annual risk-adjusted 3-, 6-, and 12-month mortality decreased significantly from 2008 to 2014 [adjusted odds ratio 0.96 (0.95–0.97), 0.96 (0.94–0.97), and 0.97 (0.95–0.98), respectively]. A similar significant annual decrease in risk-adjusted short-term and long-term mortality was observed in patients aged less than 80 years.
Conclusions
Both short-term and long-term risk-adjusted mortality decreased significantly during the study period in both very elderly ICU patients and patients aged less than 80 years in the Netherlands. This study clearly shows that in our setting very elderly patients benefit almost as much as their younger counterparts from improvement in quality of care over time. |
| doi_str_mv | 10.1007/s00134-017-4879-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1920203293</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A724276114</galeid><sourcerecordid>A724276114</sourcerecordid><originalsourceid>FETCH-LOGICAL-c477t-b8177517b8f359de48d5b649e7979a122ccc18b496425c8114753c1654f5f2423</originalsourceid><addsrcrecordid>eNp1ks9uFSEUxonR2Gv1AdwYEjduqMAwA7hrGqsmjW7qmjDMmdtpZpgrcJvMQ_jOnumtf3MNCYTD7_s4kI-Ql4KfCc7128y5qBTjQjNltGX2EdkIVUkmZGUekw2vlGSqUfKEPMv5Fmnd1OIpOZFGcy1MvSHfrxPELtMh0nwzp8IKpIn62FHBFvCJTlj041CWFbmDtFAYO0jjui8Q83AHNPgEdOfLALHcW5UboJ8B5zSiVX5HPU1Q0px3EMqqyGXfLbRP80Ql54aWGVehnpMnvR8zvHhYT8nXy_fXFx_Z1ZcPny7Or1hQWhfWGqF1LXRr-qq2HSjT1W2jLGirrRdShhCEaZXFp9fBCKF0XQXR1Kqve6lkdUreHHx3af62h1zcNOQAI3YL8z47YSWXvJK2QvT1P-jtvE8Ru0NKISit4r-prR_BDbGfS_JhNXXnGm_UDTaBFDtCbSFC8uMcoR-w_Bd_doTH0cE0hKMCcRAE_OucoHe7NEw-LU5wt0bGHSLjMAlujYyzqHn18MB9O0H3S_EzIwjIA5DxKG4h_fED_3X9AZWdyAo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1941922940</pqid></control><display><type>article</type><title>Trends in short-term and 1-year mortality in very elderly intensive care patients in the Netherlands: a retrospective study from 2008 to 2014</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Karakus, Attila ; Haas, Lenneke E. M. ; Brinkman, Sylvia ; de Lange, Dylan W. ; de Keizer, Nicolette F.</creator><creatorcontrib>Karakus, Attila ; Haas, Lenneke E. M. ; Brinkman, Sylvia ; de Lange, Dylan W. ; de Keizer, Nicolette F.</creatorcontrib><description>Purpose
To describe the trends in short-term and long-term mortality in very elderly intensive care unit (ICU) patients between 2008 and 2014.
Methods
A retrospective cohort study was conducted using data from the National Intensive Care Evaluation Foundation from 31 Dutch ICUs. Generalized linear mixed-effects models were used to determine the change in adjusted short-term mortality (ICU/hospital deaths) and long-term mortality (3, 6, and 12 months after ICU admission) over the period 2008–2014 in very elderly patients and in patients less than 80 years old admitted to the ICU.
Results
A total of 216,196 patients admitted to 31 ICUs in the period from 2008 to 2014 were included in the study, including 28,284 (13.1%) very elderly patients (80 years or older). Follow-up data for determination of 3-, 6-, and 12-month mortality were available for, respectively, 210,005 (97.1%), 202,551 (93.7%), and 176,847 (81.8%) ICU admissions. The crude ICU and in-hospital mortality decreased, respectively, from 17.6% to 13.0% and from 30.7% to 21.0%. The annual risk-adjusted ICU and in-hospital mortality of very elderly patients (adjusted for APACHE III score, comorbidities, and admission type) decreased significantly during the study period [adjusted odds ratio 0.97 (0.95–0.99) and 0.92 (0.91–0.93), respectively]. Additionally, the annual risk-adjusted 3-, 6-, and 12-month mortality decreased significantly from 2008 to 2014 [adjusted odds ratio 0.96 (0.95–0.97), 0.96 (0.94–0.97), and 0.97 (0.95–0.98), respectively]. A similar significant annual decrease in risk-adjusted short-term and long-term mortality was observed in patients aged less than 80 years.
Conclusions
Both short-term and long-term risk-adjusted mortality decreased significantly during the study period in both very elderly ICU patients and patients aged less than 80 years in the Netherlands. This study clearly shows that in our setting very elderly patients benefit almost as much as their younger counterparts from improvement in quality of care over time.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-017-4879-9</identifier><identifier>PMID: 28707185</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age Factors ; Aged patients ; Aged, 80 and over ; Anesthesiology ; APACHE ; Critical Care Medicine ; Critical Care Outcomes ; Critical Illness - mortality ; Emergency Medicine ; Female ; Geriatrics ; Health risk assessment ; Hospital Mortality ; Hospital patients ; Hospitalization - statistics & numerical data ; Humans ; Intensive ; Intensive care ; Linear Models ; Longitudinal Studies ; Male ; Medical care ; Medicine ; Medicine & Public Health ; Mortality ; Netherlands - epidemiology ; Odds Ratio ; Older people ; Original ; Pain Medicine ; Patient outcomes ; Patients ; Pediatrics ; Pneumology/Respiratory System ; Quality management ; Retrospective Studies ; Risk ; Severity of Illness Index ; Short term ; Trends</subject><ispartof>Intensive care medicine, 2017-10, Vol.43 (10), p.1476-1484</ispartof><rights>Springer-Verlag GmbH Germany and ESICM 2017</rights><rights>COPYRIGHT 2017 Springer</rights><rights>Intensive Care Medicine is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-b8177517b8f359de48d5b649e7979a122ccc18b496425c8114753c1654f5f2423</citedby><cites>FETCH-LOGICAL-c477t-b8177517b8f359de48d5b649e7979a122ccc18b496425c8114753c1654f5f2423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00134-017-4879-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00134-017-4879-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28707185$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karakus, Attila</creatorcontrib><creatorcontrib>Haas, Lenneke E. M.</creatorcontrib><creatorcontrib>Brinkman, Sylvia</creatorcontrib><creatorcontrib>de Lange, Dylan W.</creatorcontrib><creatorcontrib>de Keizer, Nicolette F.</creatorcontrib><title>Trends in short-term and 1-year mortality in very elderly intensive care patients in the Netherlands: a retrospective study from 2008 to 2014</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><addtitle>Intensive Care Med</addtitle><description>Purpose
To describe the trends in short-term and long-term mortality in very elderly intensive care unit (ICU) patients between 2008 and 2014.
Methods
A retrospective cohort study was conducted using data from the National Intensive Care Evaluation Foundation from 31 Dutch ICUs. Generalized linear mixed-effects models were used to determine the change in adjusted short-term mortality (ICU/hospital deaths) and long-term mortality (3, 6, and 12 months after ICU admission) over the period 2008–2014 in very elderly patients and in patients less than 80 years old admitted to the ICU.
Results
A total of 216,196 patients admitted to 31 ICUs in the period from 2008 to 2014 were included in the study, including 28,284 (13.1%) very elderly patients (80 years or older). Follow-up data for determination of 3-, 6-, and 12-month mortality were available for, respectively, 210,005 (97.1%), 202,551 (93.7%), and 176,847 (81.8%) ICU admissions. The crude ICU and in-hospital mortality decreased, respectively, from 17.6% to 13.0% and from 30.7% to 21.0%. The annual risk-adjusted ICU and in-hospital mortality of very elderly patients (adjusted for APACHE III score, comorbidities, and admission type) decreased significantly during the study period [adjusted odds ratio 0.97 (0.95–0.99) and 0.92 (0.91–0.93), respectively]. Additionally, the annual risk-adjusted 3-, 6-, and 12-month mortality decreased significantly from 2008 to 2014 [adjusted odds ratio 0.96 (0.95–0.97), 0.96 (0.94–0.97), and 0.97 (0.95–0.98), respectively]. A similar significant annual decrease in risk-adjusted short-term and long-term mortality was observed in patients aged less than 80 years.
Conclusions
Both short-term and long-term risk-adjusted mortality decreased significantly during the study period in both very elderly ICU patients and patients aged less than 80 years in the Netherlands. This study clearly shows that in our setting very elderly patients benefit almost as much as their younger counterparts from improvement in quality of care over time.</description><subject>Age Factors</subject><subject>Aged patients</subject><subject>Aged, 80 and over</subject><subject>Anesthesiology</subject><subject>APACHE</subject><subject>Critical Care Medicine</subject><subject>Critical Care Outcomes</subject><subject>Critical Illness - mortality</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Health risk assessment</subject><subject>Hospital Mortality</subject><subject>Hospital patients</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Linear Models</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical care</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Netherlands - epidemiology</subject><subject>Odds Ratio</subject><subject>Older people</subject><subject>Original</subject><subject>Pain Medicine</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Quality management</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Severity of Illness Index</subject><subject>Short term</subject><subject>Trends</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1ks9uFSEUxonR2Gv1AdwYEjduqMAwA7hrGqsmjW7qmjDMmdtpZpgrcJvMQ_jOnumtf3MNCYTD7_s4kI-Ql4KfCc7128y5qBTjQjNltGX2EdkIVUkmZGUekw2vlGSqUfKEPMv5Fmnd1OIpOZFGcy1MvSHfrxPELtMh0nwzp8IKpIn62FHBFvCJTlj041CWFbmDtFAYO0jjui8Q83AHNPgEdOfLALHcW5UboJ8B5zSiVX5HPU1Q0px3EMqqyGXfLbRP80Ql54aWGVehnpMnvR8zvHhYT8nXy_fXFx_Z1ZcPny7Or1hQWhfWGqF1LXRr-qq2HSjT1W2jLGirrRdShhCEaZXFp9fBCKF0XQXR1Kqve6lkdUreHHx3af62h1zcNOQAI3YL8z47YSWXvJK2QvT1P-jtvE8Ru0NKISit4r-prR_BDbGfS_JhNXXnGm_UDTaBFDtCbSFC8uMcoR-w_Bd_doTH0cE0hKMCcRAE_OucoHe7NEw-LU5wt0bGHSLjMAlujYyzqHn18MB9O0H3S_EzIwjIA5DxKG4h_fED_3X9AZWdyAo</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Karakus, Attila</creator><creator>Haas, Lenneke E. M.</creator><creator>Brinkman, Sylvia</creator><creator>de Lange, Dylan W.</creator><creator>de Keizer, Nicolette F.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20171001</creationdate><title>Trends in short-term and 1-year mortality in very elderly intensive care patients in the Netherlands: a retrospective study from 2008 to 2014</title><author>Karakus, Attila ; Haas, Lenneke E. M. ; Brinkman, Sylvia ; de Lange, Dylan W. ; de Keizer, Nicolette F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-b8177517b8f359de48d5b649e7979a122ccc18b496425c8114753c1654f5f2423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age Factors</topic><topic>Aged patients</topic><topic>Aged, 80 and over</topic><topic>Anesthesiology</topic><topic>APACHE</topic><topic>Critical Care Medicine</topic><topic>Critical Care Outcomes</topic><topic>Critical Illness - mortality</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Health risk assessment</topic><topic>Hospital Mortality</topic><topic>Hospital patients</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Linear Models</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical care</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Netherlands - epidemiology</topic><topic>Odds Ratio</topic><topic>Older people</topic><topic>Original</topic><topic>Pain Medicine</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Quality management</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Severity of Illness Index</topic><topic>Short term</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karakus, Attila</creatorcontrib><creatorcontrib>Haas, Lenneke E. M.</creatorcontrib><creatorcontrib>Brinkman, Sylvia</creatorcontrib><creatorcontrib>de Lange, Dylan W.</creatorcontrib><creatorcontrib>de Keizer, Nicolette F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karakus, Attila</au><au>Haas, Lenneke E. M.</au><au>Brinkman, Sylvia</au><au>de Lange, Dylan W.</au><au>de Keizer, Nicolette F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in short-term and 1-year mortality in very elderly intensive care patients in the Netherlands: a retrospective study from 2008 to 2014</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><addtitle>Intensive Care Med</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>43</volume><issue>10</issue><spage>1476</spage><epage>1484</epage><pages>1476-1484</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><abstract>Purpose
To describe the trends in short-term and long-term mortality in very elderly intensive care unit (ICU) patients between 2008 and 2014.
Methods
A retrospective cohort study was conducted using data from the National Intensive Care Evaluation Foundation from 31 Dutch ICUs. Generalized linear mixed-effects models were used to determine the change in adjusted short-term mortality (ICU/hospital deaths) and long-term mortality (3, 6, and 12 months after ICU admission) over the period 2008–2014 in very elderly patients and in patients less than 80 years old admitted to the ICU.
Results
A total of 216,196 patients admitted to 31 ICUs in the period from 2008 to 2014 were included in the study, including 28,284 (13.1%) very elderly patients (80 years or older). Follow-up data for determination of 3-, 6-, and 12-month mortality were available for, respectively, 210,005 (97.1%), 202,551 (93.7%), and 176,847 (81.8%) ICU admissions. The crude ICU and in-hospital mortality decreased, respectively, from 17.6% to 13.0% and from 30.7% to 21.0%. The annual risk-adjusted ICU and in-hospital mortality of very elderly patients (adjusted for APACHE III score, comorbidities, and admission type) decreased significantly during the study period [adjusted odds ratio 0.97 (0.95–0.99) and 0.92 (0.91–0.93), respectively]. Additionally, the annual risk-adjusted 3-, 6-, and 12-month mortality decreased significantly from 2008 to 2014 [adjusted odds ratio 0.96 (0.95–0.97), 0.96 (0.94–0.97), and 0.97 (0.95–0.98), respectively]. A similar significant annual decrease in risk-adjusted short-term and long-term mortality was observed in patients aged less than 80 years.
Conclusions
Both short-term and long-term risk-adjusted mortality decreased significantly during the study period in both very elderly ICU patients and patients aged less than 80 years in the Netherlands. This study clearly shows that in our setting very elderly patients benefit almost as much as their younger counterparts from improvement in quality of care over time.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28707185</pmid><doi>10.1007/s00134-017-4879-9</doi><tpages>9</tpages></addata></record> |
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| ispartof | Intensive care medicine, 2017-10, Vol.43 (10), p.1476-1484 |
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| subjects | Age Factors Aged patients Aged, 80 and over Anesthesiology APACHE Critical Care Medicine Critical Care Outcomes Critical Illness - mortality Emergency Medicine Female Geriatrics Health risk assessment Hospital Mortality Hospital patients Hospitalization - statistics & numerical data Humans Intensive Intensive care Linear Models Longitudinal Studies Male Medical care Medicine Medicine & Public Health Mortality Netherlands - epidemiology Odds Ratio Older people Original Pain Medicine Patient outcomes Patients Pediatrics Pneumology/Respiratory System Quality management Retrospective Studies Risk Severity of Illness Index Short term Trends |
| title | Trends in short-term and 1-year mortality in very elderly intensive care patients in the Netherlands: a retrospective study from 2008 to 2014 |
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