Acute and Critical Care

Original Articles

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Demographic Changes in Intensive Care Units in Korea over the Last Decade and Outcomes of Elderly Patients: A Single-Center Retrospective Study: Jeong Uk Lim, Jongmin Lee, Jick Hwan Ha, Hyeon Hui Kang, Sang Haak Lee, Hwa Sik Moon; Korean J Crit Care Med. 2017;32(2):164-173. Published online May 31, 2017; DOI: https://doi.org/10.4266/kjccm.2016.00668

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Background
Aging is a significant issue worldwide, and Korea is one of the most rapidly aging countries. Along with the demographic transition, the age structure of intensive care unit (ICU) patients changes as well.
Methods
The aim of this study was to analyze the change in age distribution of the ICU patients over the last 10 years and its effect on clinical outcomes. Single-center, retrospective analysis of all patients aged ≥18 years admitted to either the medical or surgical ICU at St. Paul’s Hospital, The Catholic University of Korea, between January 2005 and December 2014 was conducted. For clinical outcome, in-hospital mortality, duration of ICU stay, and hospital stay were analyzed. Cost analysis was performed to show the economic burden of each age strata.
Results
A total of 10,366 ICU patients were admitted to the chosen ICUs during the study period. The proportion of elderly patients aged ≥65 years increased from 47.9% in 2005 to 63.7% in 2014, and the proportion of the very elderly patients aged ≥80 years increased from 12.8% to 20.7%. However, this increased proportion of elderly patients did not lead to increased in-hospital mortality. The percent of ICU treatment days attributable to elderly patients increased from 51.1% in year 2005 to 64.0% in 2014. The elderly ICU patients were associated with higher in-hospital mortality compared to younger age groups.
Conclusions
The proportion of elderly patients admitted to ICUs increased over the last decade. However, overall in-hospital mortality has not increased during the same period.

Citations

Citations to this article as recorded by

Impact of lipopolysaccharide-induced acute lung injury in aged mice
Sukjin Bae, In Kyoung Kim, Jeonghyeon Im, Heayon Lee, Sang Haak Lee, Sei Won Kim
Experimental Lung Research.2023; 49(1): 193. CrossRef
Perfil de mortalidade de idosos jovens hospitalizados em uma unidade de terapia intensiva
Jeferson Moreira dos Santos, Ricardo Franklin De Freitas Mussi , Jessica Lane Pereira Santos , Larissa Chaves Pedreira Silva, Maria Antônia Alves de Souza
Ciência, Cuidado e Saúde.2023;[Epub] CrossRef
Characteristics and prognostic factors of very elderly patients admitted to the intensive care unit
Song-I Lee, Younsuck Koh, Jin Won Huh, Sang-Bum Hong, Chae-Man Lim
Acute and Critical Care.2022; 37(3): 372. CrossRef
Retrospective Analysis of Long-Term Survival in Very Elderly (age ≥80) Critically Ill Patients of a Medical Intensive Care Unit at a Tertiary Care Hospital in Korea
Seung Hun Lee, Ju-Young Kim, Tae Hoon Kim, Sun Mi Ju, Jung-Wan Yoo, Seung Jun Lee, Yu Ji Cho, Yi Yeong Jeong, Jong Deog Lee, Ho Cheol Kim
Tuberculosis and Respiratory Diseases.2020; 83(3): 242. CrossRef
Should Very Old Patients Be Admitted to the Intensive Care Units?
Jun Kwon Cha, In-Ae Song
The Korean Journal of Critical Care Medicine.2017; 32(4): 376. CrossRef

Cardiology/Pulmonary
Clinical Characteristics of Respiratory Extracorporeal Life Support in Elderly Patients with Severe Acute Respiratory Distress Syndrome: Woo Hyun Cho, Dong Wan Kim, Hye Ju Yeo, Seong Hoon Yoon, Seung Eun Lee, Doo Soo Jeon, Yun Seong Kim, Bong Soo Son, Do Hyung Kim; Korean J Crit Care Med. 2014;29(4):266-272. Published online November 30, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.4.266

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Abstract PDF

BACKGROUND
Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS.
METHODS
We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group.
RESULTS
From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock.
CONCLUSIONS
In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.

Citations

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Venovenous Extracorporeal Membrane Oxygenation for Negative Pressure Pulmonary Hemorrhage in an Elderly Patient
Kenichiro Ishida, Mitsuhiro Noborio, Nobutaka Iwasa, Taku Sogabe, Yohei Ieki, Yuki Saoyama, Kyosuke Takahashi, Yumiko Shimahara, Daikai Sadamitsu
Case Reports in Critical Care.2015; 2015: 1. CrossRef

Trauma
Mortality and Morbidity in Severely Traumatized Elderly Patients: Byungchul Yu, Min Chung, Giljae Lee, Jungnam Lee; Korean J Crit Care Med. 2014;29(2):88-92. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.88

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60 Download
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Abstract PDF

Background
As the population ages, the elderly will constitute a prominent proportion of trauma patients. The elderly suffer more severe outcomes from injuries compared with the young. In this study, we examined the relationship between mortality and complications with age.
Methods
This study was a retrospective review of 256 major trauma patients (Injury Severity Score > 15) admitted to an emergency center over a two- year period. Age-dependent mortality and complications were evaluated.
Results
Of 256 patients, 209 (81.6%) were male and the mean age was 47.2 years. There was a trend between increasing age and increasing mortality, but this was not statistically significant. Increasing age was correlated with frequency of complications.
Conclusions
Age was confirmed to be an independent predictor of mortality in major trauma. We documented that elderly trauma patients suffer from complications more frequently compared with their younger counterparts. Appropriate and specific triage and management guidelines for elderly trauma patients are needed.

Citations

Citations to this article as recorded by

Predicting mortality in elderly trauma patients: a review of the current literature
Jarva Chow, Catherine M. Kuza
Current Opinion in Anaesthesiology.2022; 35(2): 160. CrossRef
Activities of Daily Living and Determinant Factors among Older Adult Subjects with Lower Body Fracture after Discharge from Hospital: A Prospective Study
Nurul Izzah Ibrahim, Mohd Sharkawi Ahmad, Mohamed S Zulfarina, Sharifah Nurul Aqilah Sayed Mohd Zaris, Isa Naina Mohamed, Norazlina Mohamed, Sabarul Afian Mokhtar, Ahmad Nazrun Shuid
International Journal of Environmental Research and Public Health.2018; 15(5): 1002. CrossRef
Geriatric Trauma Protocol
Renee Cortez
Journal of Trauma Nursing.2018; 25(4): 218. CrossRef
Predictive Factors of Dependency in Activities of Daily Living Following Limb Trauma in the Elderly
Azade Safa, Negin Masoudi Alavi, Masoumeh Abedzadeh-Kalahroudi
Trauma Monthly.2016;[Epub] CrossRef

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