In-hospital and long-term prognosis of elderly patients requiring endotracheal intubation for life-threatening presentation of cardiogenic pulmonary edema.

Abstract:

OBJECTIVE:We studied the in-hospital course, long-term prognosis, and functional status of elderly patients with life-threatening cardiogenic pulmonary edema requiring mechanical ventilation. DESIGN:Semiprospective evaluation. SETTING:Twelve intensive care units and one emergency prehospital medical department in university hospitals. PATIENTS:Patients, aged >75 yrs, with life-threatening cardiogenic pulmonary edema requiring invasive airway management during the prehospital phase between January 1994 and January 1999 were included. INTERVENTION:None. MEASUREMENTS AND MAIN RESULTS:A total of 79 patients were studied, of which 55 were included in the prospective phase and 24 during the retrospective phase. The age range was 75-99 yrs, with a mean age of 82.4 +/- 5.9. The male/female ratio was 35:44. The in-hospital mortality was 26.6%. The mean follow-up time for all 58 survivors was 23 months (range, 2-56 months). Among those discharged, survival at 1 yr was 69%. At 3 months after hospital discharge, 49 (87%) patients lived at home, 46 (82%) were able to bathe themselves, 35 (62%) could walk at least one block, and 34 (61%) could climb one flight of stairs. CONCLUSIONS:Mortality after severe pulmonary edema requiring endotracheal intubation in a very elderly cohort has a predictably high mortality, although not related directly to the degree of presenting respiratory compromise. However, approximately 50% of the overall cohort returned to relatively good functional status, despite advanced age and a severely compromised presentation. Aggressive airway management appears, therefore, justified in this select group of patients.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Adnet F,Le Toumelin P,Leberre A,Minadeo J,Lapostolle F,Plaisance P,Cupa M

doi

10.1097/00003246-200104000-00042

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

891-5

issue

4

eissn

0090-3493

issn

1530-0293

journal_volume

29

pub_type

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