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dc.contributor.authorIbarz, Mercedes
dc.contributor.authorBoumendil, Ariane
dc.contributor.authorFlaatten, Hans
dc.contributor.authorAndersen, Finn Husøy
dc.contributor.authorArtigas, Antonio
dc.contributor.authorHaas, Lenneke E. M.
dc.contributor.authorIrazabal, Marian
dc.contributor.authorde Lange, Dylan W.
dc.contributor.authorMorandi, Alessandro
dc.contributor.authorBertolini, Guido
dc.contributor.authorCecconi, Maurizio
dc.contributor.authorChristensen, Stefen
dc.contributor.authorFaraldi, Loredana
dc.contributor.authorFjølner, Jesper
dc.contributor.authorJung, Christian
dc.contributor.authorMarsh, Brian
dc.contributor.authorMoreno, Rui
dc.contributor.authorOeyen, Sandra
dc.contributor.authorÖhman, Christina Agwald
dc.contributor.authorPinto, Bernardo Bollen
dc.contributor.authorSoliman, Ivo W.
dc.contributor.authorValentin, Andreas
dc.contributor.authorSzczeklik, Wojciech
dc.contributor.authorWatson, Ximena
dc.contributor.authorZaferidis, Tilemachos
dc.contributor.authorGuidet, Bertrand
dc.contributor.authorArtigas, Antonio
dc.date.accessioned2021-06-21T07:32:38Z
dc.date.available2021-06-21T07:32:38Z
dc.date.created2020-07-21T11:18:23Z
dc.date.issued2020
dc.identifier.issn2110-5820
dc.identifier.urihttps://hdl.handle.net/11250/2760297
dc.description.abstractBackground The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival. Results This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81–86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7, p < 0.0001), required more vasoactive drugs [82.2% vs. 55.1%, p < 0.0001] and renal replacement therapies [17.4% vs. 9.9%; p < 0.0001], and had more life-sustaining treatment limitations [37.3% vs. 32.1%; p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86–1.15), p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87–1.17), p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day survival was similar in both groups [57.2% (95% CI 52.7–60.7) vs. 57.1% (95% CI 53.7–60.1), p = 0.85]. Conclusions After adjusting for organ dysfunction, sepsis at admission was not independently associated with decreased 30-day survival in this multinational study of 3869 VIPs. Age, frailty, and SOFA score were independently associated with survival.en_US
dc.language.isoengen_US
dc.publisherSpringerOpenen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.titleSepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort studyen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright The Author(s) 2020en_US
dc.source.articlenumber56en_US
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode1
dc.identifier.doi10.1186/s13613-020-00672-w
dc.identifier.cristin1819999
dc.source.journalAnnals of Intensive Careen_US
dc.identifier.citationAnnals of Intensive Care. 2020, 10, 56.en_US
dc.source.volume10en_US


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Navngivelse 4.0 Internasjonal
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