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Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU.

de Lange, DW; Brinkman, S; Flaatten, H; Boumendil, A; Morandi, A; Andersen, FH; Artigas, A; Bertolini, G; Cecconi, M; Christensen, S; et al. de Lange, DW; Brinkman, S; Flaatten, H; Boumendil, A; Morandi, A; Andersen, FH; Artigas, A; Bertolini, G; Cecconi, M; Christensen, S; Faraldi, L; Fjølner, J; Jung, C; Marsh, B; Moreno, R; Oeyen, S; Öhman, CA; Bollen Pinto, B; de Smet, AMGA; Soliman, IW; Szczeklik, W; Valentin, A; Watson, X; Zafeiridis, T; Guidet, B; VIP1 Study Group (2019) Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU. J Am Geriatr Soc, 67 (6). pp. 1263-1267. ISSN 1532-5415 https://doi.org/10.1111/jgs.15888
SGUL Authors: Cecconi, Maurizio

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Abstract

OBJECTIVES: To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN: Prospective cohort study. SETTING: A total of 306 ICUs from 24 European countries. PARTICIPANTS: Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81-87 y]; 51.8% male). MEASUREMENTS: Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30-day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves. RESULTS: The 30-day-mortality was 1562 (41.9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis, Clinical Frailty Scale, Sequential Organ Failure Score, invasive mechanical ventilation, and renal replacement therapy. The discrimination, accuracy, and calibration of the model were good: the area under the curve for a score of 10 or higher was .80, and the Brier score was .18. At a cut point of 10 or higher (75% of all patients), the model predicts 30-day mortality in 91.1% of all patients who die. CONCLUSION: A predictive model of cumulative events predicts 30-day mortality in patients older than 80 years admitted to ICUs. Future studies should include other potential predictor variables including functional status, presence of advance care plans, and assessment of each patient's decision-making capacity.

Item Type: Article
Additional Information: © 2019 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: critical care, model, older adults, predict, prognosis, VIP1 Study Group, critical care, prognosis, older adults, predict, model, 11 Medical And Health Sciences, Geriatrics
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Vascular & Cardiac Surgery (INCCVC)
Journal or Publication Title: J Am Geriatr Soc
ISSN: 1532-5415
Language: eng
Dates:
DateEvent
12 June 2019Published
12 April 2019Published Online
21 February 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 30977911
Web of Science ID: WOS:000471133600027
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111121
Publisher's version: https://doi.org/10.1111/jgs.15888

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