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Title: Outcomes of older people receiving intensive care in Victoria.
Austin Authors: Duke, Graeme J;Barker, Anna;Knott, Cameron I ;Santamaria, John D
Affiliation: St Vincents Hospital Melbourne, Melbourne, VIC, Australia
Box Hill Hospital, Melbourne, VIC, Australia
Austin Health, Heidelberg, Victoria, Australia, Australia
Centre of Research Execllence in Patient Safety, Monash University, Melbourne, VIC, Australia
Issue Date: 7-Apr-2014
Publication information: Medical Journal of Australia; 200(6): 323-6
Abstract: OBJECTIVE To assess trends in service use and outcome of critically ill older people (aged ≥ 65 years) admitted to an intensive care unit (ICU).Retrospective cohort analysis of administrative data on older patients discharged from ICUs at all 23 adult public hospitals with onsite ICUs in Victoria between 1 July 1999 and 30 June 2011. Subgroups examined included those aged ≥ 80 years, major diagnosis categories, and those receiving mechanical ventilation.Resource use and hospital survival; also length of stay (LOS) and discharge destination trends.Over 12 years, 108,171 people aged ≥ 65 years were admitted to ICUs; of these, 49,912 (46.1%) received mechanical ventilation and 17,772 (16.4%) died. Despite an increase in the older age population (2.5% per annum) and acute care admissions (7.3% per annum) over the period studied, there was a net reversal in prevalence trends for ICU admissions (- 1.7% per annum; P = 0.04) and admissions of patients requiring mechanical ventilation (- 1.6% per annum) in the 8 years since 2004. Annual risk-adjusted mortality fell (odds ratio, 0.97 per year; 95% CI, 0.96-0.97 per year; P < 0.001) without prolongation of hospital or ICU LOS (P = 0.49) or discharge to residential aged care (RAC). Similar trends were noted in all a priori subgroups.Improved hospital survival without an increase in demand for ICU admission or RAC or an increase in LOS suggests there has been improvement in the care of the older age population.
Gov't Doc #: 24702089
Journal: Medical Journal of Australia
Type: Journal Article
Subjects: Aged
Aged, 80 and over
Cohort Studies
Critical Illness.therapy
Hospital Mortality
Intensive Care.statistics & numerical data.utilization
Intensive Care Units.statistics & numerical data.utilization
Length of Stay.statistics & numerical data
Logistic Models
Odds Ratio
Outcome Assessment (Health Care)
Patient Discharge.statistics & numerical data
Respiration, Artificial.statistics & numerical data.utilization
Retrospective Studies
Appears in Collections:Journal articles

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