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Critically ill patient mortality by age: long-term follow-up (CIMbA-LT)

dc.contributor.authorGonçalves-Pereira, João
dc.contributor.authorOliveira, André
dc.contributor.authorVieira, Tatiana
dc.contributor.authorRodrigues, Ana Rita
dc.contributor.authorPinto, Maria João
dc.contributor.authorPipa, Sara
dc.contributor.authorMartinho, Ana
dc.contributor.authorRibeiro, Sofia
dc.contributor.authorPaiva, José-Artur
dc.date.accessioned2023-07-27T10:31:06Z
dc.date.available2023-07-27T10:31:06Z
dc.date.issued2023-02-11
dc.description.abstractBackground The past years have witnessed dramatic changes in the population admitted to the intensive care unit (ICU). Older and sicker patients are now commonly treated in this setting due to the newly available sophisticated life support. However, the short- and long-term benefit of this strategy is scarcely studied. Methods The Critically Ill patients’ mortality by age: Long-Term follow-up (CIMbA-LT) was a multicentric, nationwide, retrospective, observational study addressing short- and long-term prognosis of patients admitted to Portuguese multipurpose ICUs, during 4 years, according to their age and disease severity. Patients were followed for two years after ICU admission. The standardized hospital mortality ratio (SMR) was calculated according to the Simplified Acute Physiology Score (SAPS) II and the follow-up risk, for patients discharged alive from the hospital, according to official demographic national data for age and gender. Survival curves were plotted according to age group. Results We included 37.118 patients, including 15.8% over 80 years old. The mean SAPS II score was 42.8 ± 19.4. The ICU all-cause mortality was 16.1% and 76% of all patients survive until hospital discharge. The SAPS II score overestimated hospital mortality [SMR at hospital discharge 0.7; 95% confidence interval (CI) 0.63–0.76] but accurately predicted one-year all-cause mortality [1-year SMR 1.01; (95% CI 0.98–1.08)]. Survival curves showed a peak in mortality, during the first 30 days, followed by a much slower survival decline thereafter. Older patients had higher short- and long-term mortality and their hospital SMR was also slightly higher (0.76 vs. 0.69). Patients discharged alive from the hospital had a 1-year relative mortality risk of 6.3; [95% CI 5.8–6.7]. This increased risk was higher for younger patients [21.1; (95% CI 15.1–39.6) vs. 2.4; (95% CI 2.2–2.7) for older patients]. Conclusions Critically ill patients’ mortality peaked in the first 30 days after ICU admission. Older critically ill patients had higher all-cause mortality, including a higher hospital SMR. A long-term increased relative mortality risk was noted in patients discharged alive from the hospital, but this was more noticeable in younger patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1186/s13613-023-01102-3pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.26/45742
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectFollow-uppt_PT
dc.subjectLong termpt_PT
dc.subjectAgept_PT
dc.subjectSurvivalpt_PT
dc.subjectMortalitypt_PT
dc.subjectSAPS-IIpt_PT
dc.subjectStandard mortality ratiopt_PT
dc.titleCritically ill patient mortality by age: long-term follow-up (CIMbA-LT)pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.titleAnnals of Intensive Carept_PT
oaire.citation.volume13pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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