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J Gerontol A Biol Sci Med Sci. 2014 Oct;69(10):1291-8. doi: 10.1093/gerona/glu051. Epub 2014 Apr 10.

Amount of care per survivor in young and older patients hospitalized in intensive care unit: a retrospective study.

Author information

1
Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, France.
2
UPRES EA 4638, LUNAM, Angers University, France. Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, France. Angers University Memory Clinic, France.
3
UPRES EA 4638, LUNAM, Angers University, France. Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, France. Angers University Memory Clinic, France. Robarts Research Institute, London, Ontario, Canada. Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.
4
Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, France. nicolas.lerolle@univ-angers.fr.

Abstract

BACKGROUND:

It is unknown whether the amount of care deployed in the intensive care unit population divided by the number of survivors, that is, amount of care per survivor including the care performed for nonsurvivors, differs between patients older and younger than 75 years of age.

METHODS:

Data were extracted from the computerized files of all 2,220 patients admitted in a medical intensive care unit between January 2009 and December 2010. Patients ≥75 and <75 years old were compared. The Omega score per survivor (OMEGA/S) was calculated in both age groups by dividing the total amount of Omega points, a score of cumulated care load calculated over intensive care unit stay, by the number of survivors in each group.

RESULTS:

OMEGA/S was 26% higher in elderly versus younger patients when considering intensive care unit mortality and 40% higher when considering hospital mortality. The absence of difference in raw Omega values between the two groups implies that OMEGA/S differences were related to differences in mortality rate. Simplified Acute Physiology Score II (without age-related points) strata analysis (<20, 20-39, 40-59, 60-79, and ≥80) showed that OMEGA/S in the elderly patients was significantly higher in the first three Simplified Acute Physiology Score II strata only. When calculating by main diagnosis categories, a major increase in the difference of OMEGA/S between elderly and younger patients was observed in cardiac arrest patients due to a major difference in mortality rate.

CONCLUSIONS:

Elderly patients required a significantly higher care load per survivor in comparison to younger patients. This excess was mainly due to patients with low initial severity.

KEYWORDS:

Cost effectiveness.; Elderly; ICU; Mortality; Outcome

PMID:
24721724
DOI:
10.1093/gerona/glu051
[Indexed for MEDLINE]
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