Abstract:
BACKGROUND:The consequences of the ageing population concerning ICU hospitalisation need to be adequately described. We believe that this discussion should be disease specific. A focus on respiratory infections is of particular interest, because it is strongly associated with old age. Our objective was to assess trends in demographics over a decade among elderly patients admitted to the ICU for acute respiratory infections. METHODS:A cross-sectional study was performed between 2006 and 2015 based on hospital discharge databases in one French region (2.5 million inhabitants). Patients with acute respiratory infection were selected according to the specific ICD-10 diagnosis codes recorded, including acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP). We also identified comorbid conditions based on any significant ICD-10 secondary diagnoses adapted from the Charlson and Elixhauser indexes. RESULTS:A total of 98,381 hospital stays for acute respiratory infection were identified among the 3,856,785 stays over the 10-year period. The number of patients 75 y/o and younger increased 1.6-fold from 2006 to 2015, whereas the numbers of patients aged 85-89 and ≥ 90 y/o increased by 2.5- and 2.1-fold, respectively. Both CAP and AECOPD hospitalisations significantly increased for all age groups over the decade. ICU hospitalisations for respiratory infection increased 2.7-fold from 2006 to 2015 (p = 0.0002). The greatest increases in the use of ICU resources were for the 85-89 and ≥ 90 y/o groups, which corresponded to increases of 3.3- and 5.8-fold. Indeed, the proportion of patients hospitalized for respiratory infection in ICU that were elderly clearly grew during the decade: 11.3% were ≥ 85 y/o in 2006 versus 16.4% in 2015 (p < 0.0001). This increase in ICU hospitalisation rate of ageing patients was not associated with significant changes in the level of care or ICU mortality except for patients ≥ 90 y/o (for whom ICU mortality dropped from 40.9 to 22.3%, p = 0.03). CONCLUSION:We observed a substantial increase in acute respiratory infection diagnoses associated with hospitalisation between 2006 and 2015, with a growing demand for critical care services. Both the absolute number and the percentage of elderly patient ICU admissions increased over the last decade, with the greatest increases being observed for patients 85 years and older.
journal_name
Ann Intensive Carejournal_title
Annals of intensive careauthors
Laporte L,Hermetet C,Jouan Y,Gaborit C,Rouve E,Shea KM,Si-Tahar M,Dequin PF,Grammatico-Guillon L,Guillon Adoi
10.1186/s13613-018-0430-6subject
Has Abstractpub_date
2018-08-15 00:00:00pages
84issue
1issn
2110-5820pii
10.1186/s13613-018-0430-6journal_volume
8pub_type
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journal_title:Annals of intensive care
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journal_title:Annals of intensive care
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abstract:BACKGROUND:Assessment of maximum respiratory pressures is a common practice in intensive care because it can predict the success of weaning from ventilation. However, the reliability of measurements through an intubation catheter has not been compared with standard measurements. The aim of this study was to compare max...
journal_title:Annals of intensive care
pub_type: 杂志文章
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journal_title:Annals of intensive care
pub_type: 杂志文章
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journal_title:Annals of intensive care
pub_type: 杂志文章
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abstract::This review examines the available evidence for targeting a specific mean arterial pressure (MAP) in sepsis resuscitation. The clinical data suggest that targeting an MAP of 65-70 mmHg in patients with septic shock who do not have chronic hypertension is a reasonable first approximation. Whereas in patients with chron...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-015-0085-5
更新日期:2015-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2012-07-05 00:00:00
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journal_title:Annals of intensive care
pub_type: 社论
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更新日期:2019-01-22 00:00:00
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journal_title:Annals of intensive care
pub_type: 信件
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更新日期:2020-10-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2012-05-30 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00666-8
更新日期:2020-04-22 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-017-0296-z
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS-CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy ...
journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2018-01-10 00:00:00
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pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00731-2
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journal_title:Annals of intensive care
pub_type: 杂志文章,评审
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更新日期:2017-12-01 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-018-0477-4
更新日期:2019-01-03 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00654-y
更新日期:2020-04-07 00:00:00
abstract:: Multiple experimental and human trials have shown that microcirculatory alterations are frequent in sepsis. In this review, we discuss the characteristics of these alterations, the various mechanisms potentially involved, and the implications for therapy. Sepsis-induced microvascular alterations are characterized by ...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-1-27
更新日期:2011-07-19 00:00:00
abstract:: Red blood cells (RBC) storage facilitates the supply of RBC to meet the clinical demand for transfusion and to avoid wastage. However, RBC storage is associated with adverse changes in erythrocytes and their preservation medium. These changes are responsible for functional alterations and for the accumulation of pote...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/2110-5820-3-2
更新日期:2013-01-15 00:00:00
abstract:BACKGROUND:Preliminary reports have described significant procoagulant events in patients with coronavirus disease-2019 (COVID-19), including life-threatening pulmonary embolism (PE). MAIN TEXT:We review the current data on the epidemiology, the possible underlying pathophysiologic mechanisms, and the therapeutic impl...
journal_title:Annals of intensive care
pub_type: 杂志文章,评审
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更新日期:2020-09-16 00:00:00
abstract:BACKGROUND:Empirical antimicrobial therapy (EAT) is a challenge for community-acquired, hospital-acquired and ventilator-associated pneumonia, particularly in the context of the increasing occurrence of third-generation cephalosporin-resistant Enterobacterales (3GCR-E), including extended-spectrum beta-lactamase Entero...
journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00754-9
更新日期:2020-10-29 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
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更新日期:2020-10-14 00:00:00
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journal_title:Annals of intensive care
pub_type: 杂志文章
doi:10.1186/s13613-020-00705-4
更新日期:2020-07-08 00:00:00