Outcomes of very elderly trauma ICU patients. Results from the Spanish trauma ICU registry
Abstract Objective To analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. Design A multicenter nationwide registry. Retrospective analysis. November 2012–May 2017. Setting Parti...
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| Veröffentlicht in: | Medicina intensiva 2020-05, Vol.44 (4), p.210-215 |
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| creator | Chico-Fernández, M Sánchez-Casado, M Barea-Mendoza, J.A García-Sáez, I Ballesteros-Sanz, M.Á Guerrero-López, F Quintana-Díaz, M Molina-Díaz, I Martín-Iglesias, L Toboso-Casado, J.M Pérez-Bárcena, J Llompart-Pou, J.A |
| description | Abstract Objective To analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. Design A multicenter nationwide registry. Retrospective analysis. November 2012–May 2017. Setting Participating ICUs. Patients Trauma patients aged ≥80 years. Interventions None. Main variables of interest The outcomes and influence of limitation of life sustaining therapy (LLST) were analyzed. Comparisons were established using the Wilcoxon test, Chi-squared test or Fisher's exact test as appropriate. Multiple logistic regression analysis was performed to analyze variables related to mortality. A p -value |
| doi_str_mv | 10.1016/j.medin.2019.01.006 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2185872699</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0210569119300348</els_id><sourcerecordid>2185872699</sourcerecordid><originalsourceid>FETCH-LOGICAL-c414t-4c80680d30ff36a5de544df04d10d5d4defdc562434903ac54fd688718ee50243</originalsourceid><addsrcrecordid>eNqFkU2LFDEQhoMo7uzqLxAkRy_dVrqTdHJQkEHXhYWF_bh4CTGpdjP2x5ikF_rfm3FWES-eClLPW0WeIuQVg5oBk2939Yg-THUDTNfAagD5hGyY6FQlO66fkg00DCohNTshpyntABqhOTwnJy10WgNvNuTL1ZLdPGKic08fMK4UB49xWGmOdhktvdje0b3NAaecanqNaRlyon2cR5rvkd7s7RTS_d90xG8h5bi-IM96OyR8-VjPyN2nj7fbz9Xl1fnF9sNl5TjjueJOgVTgW-j7VlrhUXDue-CegReee-y9E7LhLdfQWid476VSHVOIAsrzGXlznLuP848FUzZjSA6HwU44L8k0TAnVNVLrgrZH1MU5pYi92ccw2rgaBuYg1ezML6nmINUAM0VqSb1-XLB8Ld0_md8WC_DuCGD55kPAaJIrwlyZFNFl4-fwnwXv_8m7IUzB2eE7rph28xKnYtAwkxoD5uZw18NZmW4BWq7an06nnZI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2185872699</pqid></control><display><type>article</type><title>Outcomes of very elderly trauma ICU patients. Results from the Spanish trauma ICU registry</title><source>Access via ScienceDirect (Elsevier)</source><creator>Chico-Fernández, M ; Sánchez-Casado, M ; Barea-Mendoza, J.A ; García-Sáez, I ; Ballesteros-Sanz, M.Á ; Guerrero-López, F ; Quintana-Díaz, M ; Molina-Díaz, I ; Martín-Iglesias, L ; Toboso-Casado, J.M ; Pérez-Bárcena, J ; Llompart-Pou, J.A</creator><creatorcontrib>Chico-Fernández, M ; Sánchez-Casado, M ; Barea-Mendoza, J.A ; García-Sáez, I ; Ballesteros-Sanz, M.Á ; Guerrero-López, F ; Quintana-Díaz, M ; Molina-Díaz, I ; Martín-Iglesias, L ; Toboso-Casado, J.M ; Pérez-Bárcena, J ; Llompart-Pou, J.A ; On behalf of the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC) ; Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)</creatorcontrib><description>Abstract Objective To analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. Design A multicenter nationwide registry. Retrospective analysis. November 2012–May 2017. Setting Participating ICUs. Patients Trauma patients aged ≥80 years. Interventions None. Main variables of interest The outcomes and influence of limitation of life sustaining therapy (LLST) were analyzed. Comparisons were established using the Wilcoxon test, Chi-squared test or Fisher's exact test as appropriate. Multiple logistic regression analysis was performed to analyze variables related to mortality. A p -value <0.05 was considered statistically significant. Results The mean patient age was 83.4 ± 3.3 years; 281 males (60.4%). Low-energy falls were the mechanisms of injury in 256 patients (55.1%). The mean ISS was 20.5 ± 11.1, with a mean ICU stay of 7.45 ± 9.9 days. The probability of survival based on the TRISS methodology was 69.8 ± 29.7%. The ICU mortality rate was 15.5%, with an in-hospital mortality rate of 19.2%. The main cause of mortality was intracranial hypertension (42.7%). The ISS, the need for first- and second-tier measures to control intracranial pressure, and being admitted to the ICU for organ donation were independent mortality predictors. LLST was applied in 128 patients (27.9%). Patients who received LLST were older, with more severe trauma, and with more severe brain injury. Conclusions Very elderly trauma ICU patients presented mortality rates lower than predicted on the basis of the severity of injury.</description><identifier>ISSN: 0210-5691</identifier><identifier>EISSN: 1578-6749</identifier><identifier>DOI: 10.1016/j.medin.2019.01.006</identifier><identifier>PMID: 30799042</identifier><language>eng</language><publisher>Spain: Elsevier España, S.L.U</publisher><subject>Critical Care ; Geriatric trauma ; Intensive care unit ; Mortalidad ; Mortality ; Pacientes muy ancianos ; RETRAUCI ; Trauma geriátrico ; Traumatic brain injury ; Traumatismo craneoencefálico ; Unidad de cuidados intensivos ; Very elderly patients</subject><ispartof>Medicina intensiva, 2020-05, Vol.44 (4), p.210-215</ispartof><rights>Elsevier España, S.L.U. y SEMICYUC</rights><rights>2019 Elsevier España, S.L.U. y SEMICYUC</rights><rights>Copyright © 2019 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c414t-4c80680d30ff36a5de544df04d10d5d4defdc562434903ac54fd688718ee50243</citedby><cites>FETCH-LOGICAL-c414t-4c80680d30ff36a5de544df04d10d5d4defdc562434903ac54fd688718ee50243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.medin.2019.01.006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30799042$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chico-Fernández, M</creatorcontrib><creatorcontrib>Sánchez-Casado, M</creatorcontrib><creatorcontrib>Barea-Mendoza, J.A</creatorcontrib><creatorcontrib>García-Sáez, I</creatorcontrib><creatorcontrib>Ballesteros-Sanz, M.Á</creatorcontrib><creatorcontrib>Guerrero-López, F</creatorcontrib><creatorcontrib>Quintana-Díaz, M</creatorcontrib><creatorcontrib>Molina-Díaz, I</creatorcontrib><creatorcontrib>Martín-Iglesias, L</creatorcontrib><creatorcontrib>Toboso-Casado, J.M</creatorcontrib><creatorcontrib>Pérez-Bárcena, J</creatorcontrib><creatorcontrib>Llompart-Pou, J.A</creatorcontrib><creatorcontrib>On behalf of the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)</creatorcontrib><creatorcontrib>Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)</creatorcontrib><title>Outcomes of very elderly trauma ICU patients. Results from the Spanish trauma ICU registry</title><title>Medicina intensiva</title><addtitle>Med Intensiva</addtitle><description>Abstract Objective To analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. Design A multicenter nationwide registry. Retrospective analysis. November 2012–May 2017. Setting Participating ICUs. Patients Trauma patients aged ≥80 years. Interventions None. Main variables of interest The outcomes and influence of limitation of life sustaining therapy (LLST) were analyzed. Comparisons were established using the Wilcoxon test, Chi-squared test or Fisher's exact test as appropriate. Multiple logistic regression analysis was performed to analyze variables related to mortality. A p -value <0.05 was considered statistically significant. Results The mean patient age was 83.4 ± 3.3 years; 281 males (60.4%). Low-energy falls were the mechanisms of injury in 256 patients (55.1%). The mean ISS was 20.5 ± 11.1, with a mean ICU stay of 7.45 ± 9.9 days. The probability of survival based on the TRISS methodology was 69.8 ± 29.7%. The ICU mortality rate was 15.5%, with an in-hospital mortality rate of 19.2%. The main cause of mortality was intracranial hypertension (42.7%). The ISS, the need for first- and second-tier measures to control intracranial pressure, and being admitted to the ICU for organ donation were independent mortality predictors. LLST was applied in 128 patients (27.9%). Patients who received LLST were older, with more severe trauma, and with more severe brain injury. Conclusions Very elderly trauma ICU patients presented mortality rates lower than predicted on the basis of the severity of injury.</description><subject>Critical Care</subject><subject>Geriatric trauma</subject><subject>Intensive care unit</subject><subject>Mortalidad</subject><subject>Mortality</subject><subject>Pacientes muy ancianos</subject><subject>RETRAUCI</subject><subject>Trauma geriátrico</subject><subject>Traumatic brain injury</subject><subject>Traumatismo craneoencefálico</subject><subject>Unidad de cuidados intensivos</subject><subject>Very elderly patients</subject><issn>0210-5691</issn><issn>1578-6749</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqFkU2LFDEQhoMo7uzqLxAkRy_dVrqTdHJQkEHXhYWF_bh4CTGpdjP2x5ikF_rfm3FWES-eClLPW0WeIuQVg5oBk2939Yg-THUDTNfAagD5hGyY6FQlO66fkg00DCohNTshpyntABqhOTwnJy10WgNvNuTL1ZLdPGKic08fMK4UB49xWGmOdhktvdje0b3NAaecanqNaRlyon2cR5rvkd7s7RTS_d90xG8h5bi-IM96OyR8-VjPyN2nj7fbz9Xl1fnF9sNl5TjjueJOgVTgW-j7VlrhUXDue-CegReee-y9E7LhLdfQWid476VSHVOIAsrzGXlznLuP848FUzZjSA6HwU44L8k0TAnVNVLrgrZH1MU5pYi92ccw2rgaBuYg1ezML6nmINUAM0VqSb1-XLB8Ld0_md8WC_DuCGD55kPAaJIrwlyZFNFl4-fwnwXv_8m7IUzB2eE7rph28xKnYtAwkxoD5uZw18NZmW4BWq7an06nnZI</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Chico-Fernández, M</creator><creator>Sánchez-Casado, M</creator><creator>Barea-Mendoza, J.A</creator><creator>García-Sáez, I</creator><creator>Ballesteros-Sanz, M.Á</creator><creator>Guerrero-López, F</creator><creator>Quintana-Díaz, M</creator><creator>Molina-Díaz, I</creator><creator>Martín-Iglesias, L</creator><creator>Toboso-Casado, J.M</creator><creator>Pérez-Bárcena, J</creator><creator>Llompart-Pou, J.A</creator><general>Elsevier España, S.L.U</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200501</creationdate><title>Outcomes of very elderly trauma ICU patients. Results from the Spanish trauma ICU registry</title><author>Chico-Fernández, M ; Sánchez-Casado, M ; Barea-Mendoza, J.A ; García-Sáez, I ; Ballesteros-Sanz, M.Á ; Guerrero-López, F ; Quintana-Díaz, M ; Molina-Díaz, I ; Martín-Iglesias, L ; Toboso-Casado, J.M ; Pérez-Bárcena, J ; Llompart-Pou, J.A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c414t-4c80680d30ff36a5de544df04d10d5d4defdc562434903ac54fd688718ee50243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Critical Care</topic><topic>Geriatric trauma</topic><topic>Intensive care unit</topic><topic>Mortalidad</topic><topic>Mortality</topic><topic>Pacientes muy ancianos</topic><topic>RETRAUCI</topic><topic>Trauma geriátrico</topic><topic>Traumatic brain injury</topic><topic>Traumatismo craneoencefálico</topic><topic>Unidad de cuidados intensivos</topic><topic>Very elderly patients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chico-Fernández, M</creatorcontrib><creatorcontrib>Sánchez-Casado, M</creatorcontrib><creatorcontrib>Barea-Mendoza, J.A</creatorcontrib><creatorcontrib>García-Sáez, I</creatorcontrib><creatorcontrib>Ballesteros-Sanz, M.Á</creatorcontrib><creatorcontrib>Guerrero-López, F</creatorcontrib><creatorcontrib>Quintana-Díaz, M</creatorcontrib><creatorcontrib>Molina-Díaz, I</creatorcontrib><creatorcontrib>Martín-Iglesias, L</creatorcontrib><creatorcontrib>Toboso-Casado, J.M</creatorcontrib><creatorcontrib>Pérez-Bárcena, J</creatorcontrib><creatorcontrib>Llompart-Pou, J.A</creatorcontrib><creatorcontrib>On behalf of the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)</creatorcontrib><creatorcontrib>Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medicina intensiva</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chico-Fernández, M</au><au>Sánchez-Casado, M</au><au>Barea-Mendoza, J.A</au><au>García-Sáez, I</au><au>Ballesteros-Sanz, M.Á</au><au>Guerrero-López, F</au><au>Quintana-Díaz, M</au><au>Molina-Díaz, I</au><au>Martín-Iglesias, L</au><au>Toboso-Casado, J.M</au><au>Pérez-Bárcena, J</au><au>Llompart-Pou, J.A</au><aucorp>On behalf of the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)</aucorp><aucorp>Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of very elderly trauma ICU patients. Results from the Spanish trauma ICU registry</atitle><jtitle>Medicina intensiva</jtitle><addtitle>Med Intensiva</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>44</volume><issue>4</issue><spage>210</spage><epage>215</epage><pages>210-215</pages><issn>0210-5691</issn><eissn>1578-6749</eissn><abstract>Abstract Objective To analyze outcomes and factors related to mortality among very elderly trauma patients admitted to intensive care units (ICUs) participating in the Spanish trauma ICU registry. Design A multicenter nationwide registry. Retrospective analysis. November 2012–May 2017. Setting Participating ICUs. Patients Trauma patients aged ≥80 years. Interventions None. Main variables of interest The outcomes and influence of limitation of life sustaining therapy (LLST) were analyzed. Comparisons were established using the Wilcoxon test, Chi-squared test or Fisher's exact test as appropriate. Multiple logistic regression analysis was performed to analyze variables related to mortality. A p -value <0.05 was considered statistically significant. Results The mean patient age was 83.4 ± 3.3 years; 281 males (60.4%). Low-energy falls were the mechanisms of injury in 256 patients (55.1%). The mean ISS was 20.5 ± 11.1, with a mean ICU stay of 7.45 ± 9.9 days. The probability of survival based on the TRISS methodology was 69.8 ± 29.7%. The ICU mortality rate was 15.5%, with an in-hospital mortality rate of 19.2%. The main cause of mortality was intracranial hypertension (42.7%). The ISS, the need for first- and second-tier measures to control intracranial pressure, and being admitted to the ICU for organ donation were independent mortality predictors. LLST was applied in 128 patients (27.9%). Patients who received LLST were older, with more severe trauma, and with more severe brain injury. Conclusions Very elderly trauma ICU patients presented mortality rates lower than predicted on the basis of the severity of injury.</abstract><cop>Spain</cop><pub>Elsevier España, S.L.U</pub><pmid>30799042</pmid><doi>10.1016/j.medin.2019.01.006</doi><tpages>6</tpages></addata></record> |
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| subjects | Critical Care Geriatric trauma Intensive care unit Mortalidad Mortality Pacientes muy ancianos RETRAUCI Trauma geriátrico Traumatic brain injury Traumatismo craneoencefálico Unidad de cuidados intensivos Very elderly patients |
| title | Outcomes of very elderly trauma ICU patients. Results from the Spanish trauma ICU registry |
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