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Medical resource utilization patterns and mortality rates according to age among critically ill patients admitted to a medical intensive care unit.

ABSTRACT: There is ongoing controversy about how to address the growing demand for intensive care for critically ill elderly patients. We investigated resource utilization patterns and mortality rates according to age among critically ill patients.We retrospectively analyzed the medical records of patients admitted to a medical intensive care unit (ICU) in a tertiary referral teaching hospital between July 2006 and June 2015. Patients were categorized into non-elderly (age <65 years, n?=?4140), young-elderly (age 65-74 years, n?=?2306), and old-elderly (age ?75 years, n?=?1508) groups.Among 7954 admissions, the mean age was 61.5 years, and 5061 (63.6%) were of male patients. The proportion of comorbidities increased with age (64.6% in the non-elderly vs 81.4% in the young-elderly vs 82.8% in the old-elderly, P?

SUBMITTER: Oh DK

PROVIDER: S-EPMC6709157 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Medical resource utilization patterns and mortality rates according to age among critically ill patients admitted to a medical intensive care unit.

Oh Dong Kyu DK Na Wonjun W Park Yu Rang YR Hong Sang-Bum SB Lim Chae-Man CM Koh Younsuck Y Huh Jin-Won JW

Medicine 20190501 22

There is ongoing controversy about how to address the growing demand for intensive care for critically ill elderly patients. We investigated resource utilization patterns and mortality rates according to age among critically ill patients.We retrospectively analyzed the medical records of patients admitted to a medical intensive care unit (ICU) in a tertiary referral teaching hospital between July 2006 and June 2015. Patients were categorized into non-elderly (age <65 years, n = 4140), young-elde ...[more]

PMID: 31145326

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Project description:RationaleExisting real-time surveillance of influenza morbidity, based primarily on time-trended U.S. hospitalization and death data, is inadequate. These surveillance methods do not accurately predict hospital resource requirements or sufficiently capture the public health impact of the current influenza season.ObjectivesTo determine the feasibility and potential usefulness of tracking surrogate markers of influenza morbidity among patients hospitalized with influenza.MethodsWe performed a pilot study at three tertiary care referral hospitals and retrospectively collected and analyzed data on patients admitted with influenza during the 2013-2014 influenza season. We analyzed traditional influenza surveillance metrics, including weekly statistics on admissions and deaths, as well as weekly rates and trends of intensive care unit (ICU), mechanical ventilation, and extracorporeal membrane oxygenation (ECMO) utilization.ResultsIn our three-hospital cohort, 431 patients were hospitalized with influenza and spent a total of 1,520 days in ICUs. Eighty-six (20%) of these patients required 1,080 days of mechanical ventilation, and 17 patients (4%) received 229 days of ECMO. Trends of ICU and mechanical ventilation use were similar but differed notably from trends of ECMO use, hospitalization, and death. In particular, at two hospitals, increases in utilization of ICU and mechanical ventilation among patients with influenza occurred several weeks after increases in hospitalization rates. Furthermore, ICU, mechanical ventilation, and ECMO utilization rates at the three-hospital network remained elevated for several weeks after the influenza-associated hospitalization rate declined.ConclusionsSurrogate markers of influenza severity were feasible to collect and revealed trends of ICU resource utilization that differed notably from trends of hospitalization and death given by traditional influenza surveillance metrics. A national network of sentinel hospitals that prospectively collects, time-trends, and reports additional influenza morbidity data would be useful to hospital administrators, hospital epidemiologists, infection preventionists, and public health officials.

Dataset Information

Medical resource utilization patterns and mortality rates according to age among critically ill patients admitted to a medical intensive care unit.

Publications

Medical resource utilization patterns and mortality rates according to age among critically ill patients admitted to a medical intensive care unit.

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