Geriatrics in the Intensive Care Unit

Официальное название

Geriatrics in the Intensive Care Unit. An Observational Clinical Trial

Обзор

Life expectancy is longer in populations of medium- and high-income countries. Older adults are an increasingly large population in intensive care units (ICUs). There are limited publications about the epidemiology, benefits, expenditure, and outcomes of elderly and very old critically ill patients. We are designing a study to characterize older adults admitted to the intensive care unit and determine factors associated with adverse outcomes. The discharge registry of the ICU of a third-level hospital was reviewed. Records from January to December 2024 were reviewed. Three age groups were selected for comparison: A. \<65 years; B. 65-79 years; C. 80 years and above. The outcomes to compare will be: mortality, need for invasive mechanical ventilation, ICU length of stay, and duration of mechanical ventilation.

Подробное описание

Background: Older adults represent a significant and increasing proportion of patients admitted to the intensive care unit, as the population's life expectancy is longer. The study aims to investigate factors associated with mortality in geriatric patients receiving critical care.

Methodology: We are designing a retrospective analytical cross-sectional clinical trial. The discharge records from January to December 2024 of one of the intensive care units (ICUs) from the Orinoco region in Colombia will be reviewed. The records will be divided into three groups for comparison: A. Lower than 65 years; B. between 65 and 79 years; C. 80 years and older. The records of patients admitted to the intermediate unit will be excluded. Outcomes to be evaluated will include mortality, ICU length of stay, invasive mechanical ventilation (IMV), and duration of IMV. The data will be exported to Excel. The frequency and proportion of categorical variables will be described. The central distribution and dispersion of quantitative variables will also be defined. Chi-square and Mann-Whitney U tests will be used for the statistical comparison of the variables. A value \<0.05 of p will be designated as statistical significance.

Results: The frequency of older adults admitted to the ICU will be revealed at the end of the study. The outcomes and factors associated with mortality by age groups will be discriminated.

Conclusions: The study is feasible, pertinent, affordable, and essential for the region, as it will optimize resource planning and improve healthcare for critically ill older adults.

Вмешательства

• Другое Age group
  Observation of the outcomes by age groups.

Первичные конечные точки

• ICU mortality [Срок оценки: 30 days]

Вторичные конечные точки (3)

• ICU length of stay [Срок оценки: 30 days]
• Invasive mechanical ventilation [Срок оценки: 30 days]
• Duration of IMV [Срок оценки: 30 days]

Критерии участия

Критерии включения

• Registry of adults older than 18 years, discharged from the critical care unit.

Критерии исключения

• None.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Другое

Центры проведения

Колумбия · 1 центр

• Hospital Departamental de Villavicencio — Villavicencio

Публикации

• Heppner HJ, Haitham H. Intensive care of geriatric patients-a thin line between under- and overtreatment. Wien Med Wochenschr. 2022 Apr;172(5-6):102-108. doi: 10.1007/s10354-021-00902-1. Epub 2022 Jan 10. PMID 35006520
• Ball IM, Bagshaw SM, Burns KE, Cook DJ, Day AG, Dodek PM, Kutsogiannis DJ, Mehta S, Muscedere JG, Turgeon AF, Stelfox HT, Wells GA, Stiell IG. Outcomes of elderly critically ill medical and surgical patients: a multicentre cohort study. Can J Anaesth. 2017 Mar;64(3):260-269. doi: 10.1007/s12630-016-0798-4. Epub 2016 Dec 27. PMID 28028673
• Beil M, Flaatten H, Guidet B, Sviri S, Jung C, de Lange D, Leaver S, Fjolner J, Szczeklik W, van Heerden PV. The management of multi-morbidity in elderly patients: Ready yet for precision medicine in intensive care? Crit Care. 2021 Sep 10;25(1):330. doi: 10.1186/s13054-021-03750-y. PMID 34507597
• Beil M, Sviri S, Flaatten H, De Lange DW, Jung C, Szczeklik W, Leaver S, Rhodes A, Guidet B, van Heerden PV. On predictions in critical care: The individual prognostication fallacy in elderly patients. J Crit Care. 2021 Feb;61:34-38. doi: 10.1016/j.jcrc.2020.10.006. Epub 2020 Oct 13. PMID 33075607
• Shum HP, Chan KC, Wong HY, Yan WW. Outcome of elderly patients who receive intensive care at a regional hospital in Hong Kong. Hong Kong Med J. 2015 Dec;21(6):490-8. doi: 10.12809/hkmj144445. Epub 2015 Sep 29. PMID 26416174
• Rai S, Brace C, Ross P, Darvall J, Haines K, Mitchell I, van Haren F, Pilcher D. Characteristics and Outcomes of Very Elderly Patients Admitted to Intensive Care: A Retrospective Multicenter Cohort Analysis. Crit Care Med. 2023 Oct 1;51(10):1328-1338. doi: 10.1097/CCM.0000000000005943. Epub 2023 May 23. PMID 37219961
• Vincent JL, Creteur J. Appropriate care for the elderly in the ICU. J Intern Med. 2022 Apr;291(4):458-468. doi: 10.1111/joim.13371. Epub 2021 Oct 5. PMID 34487587
• Andersen FH, Ariansen Haaland O, Klepstad P, Flaatten H. Frailty and survival in elderly intensive care patients in Norway. Acta Anaesthesiol Scand. 2021 Sep;65(8):1065-1072. doi: 10.1111/aas.13836. Epub 2021 May 7. PMID 33896003

Идентификаторы

NCT: NCT07001410 · GRIVI_2025_01_UCI_GERIATR

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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