The effect of age on clinical outcomes in critically ill brain-injured patients

  1. Tejerina, Eva E.
  2. Gonçalves, Gesly
  3. Gómez-Mediavilla, Karen
  4. Jaramillo, Carlos
  5. Jiménez, Jorge
  6. Frutos-Vivar, Fernando
  7. Lorente, José Ángel
  8. Thuissard, Israel J.
  9. Andreu-Vázquez, Cristina
  1. 1 Hospital Universitario de Getafe
    info

    Hospital Universitario de Getafe

    Getafe, España

    ROR https://ror.org/01ehe5s81

  2. 2 Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias
    info

    Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias

    Madrid, España

  3. 3 Universidad Europea de Madrid
    info

    Universidad Europea de Madrid

    Madrid, España

    ROR https://ror.org/04dp46240

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Revista:
Acta Neurologica Belgica

ISSN: 0300-9009,  2240-2993

Año de publicación: 2022

Tipo: Artículo

DOI: 10.1007/S13760-022-01987-0 GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Acta Neurologica Belgica

Resumen

Purpose We studied the impact of age on survival and functional recovery in brain-injured patients.Methods We performed an observational cohort study of all consecutive adult patients with brain injury admitted to ICUin 8 years. To estimate the optimal cut-of point of the age associated with unfavorable outcomes (mRS 3–6), receiver operating characteristic (ROC) curve analyses were used. Multivariate logistic regression analyses were performed to identifyprognostic factors for unfavorable outcomes.Results We included 619 brain-injured patients. We identifed 60 years as the cut-of point at which the probability of unfavorable outcomes increases. Patients≥60 years had higher severity scores at ICU admission, longer duration of mechanicalventilation, longer ICU and hospital stays, and higher mortality. Factors identifed as associated with unfavorable outcomes(mRS 3–6) were an advanced age (≥60 years) [Odds ratio (OR) 4.59, 95% confdence interval (CI) 2.73–7.74, p<0.001],a low GCS score (≤8 points) [OR 3.72, 95% CI 1.95–7.08, p<0.001], the development of intracranial hypertension [OR5.52, 95% CI 2.70–11.28, p<0.001], and intracerebral hemorrhage as the cause of neurologic disease [OR 3.87, 95% CI2.34–6.42, p<0.001].Conclusion Mortality and unfavorable functional outcomes in critically ill brain-injured patients were associated with olderage (≥60 years), higher clinical severity (determined by a lower GCS score at admission and the development of intracranialhypertension), and an intracerebral hemorrhage as the cause of neurologic disease.

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Información de financiación

This study was funded by Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).

Financiadores

  • Centro de Investigación Biomédica en Red de Enfermedades Respiratorias

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