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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Validation of outcome prediction in elderly patients
1Critical Care Complex, Norfolk & Norwich Hospital, Norwich, UK.
Anaesthesia
|January 29, 2000
Summary
A new equation for predicting survival in critically ill elderly patients showed modest performance. The model requires further validation, especially for those over 85 years old, who have a poor prognosis.
Area of Science:
- Geriatric Medicine
- Critical Care Medicine
- Biostatistics
Background:
- Predicting survival in critically ill elderly patients is crucial for clinical decision-making.
- A previously developed equation aimed to estimate 1-year survival in this demographic.
Purpose of the Study:
- To validate the performance of a predictive equation for 1-year survival in critically ill patients aged over 70 years.
- To assess the equation's accuracy in a distinct patient cohort.
Main Methods:
- A validation group of 555 elderly patients admitted to intensive care were analyzed.
- Demographic details, diagnosis, and acute physiology scores were recorded.
- Patients were followed for 1 year to determine survival outcomes.
Main Results:
- The predictive equation demonstrated modest performance with a goodness-of-fit p-value of 0.04 and an area under the ROC curve of 0.75.
- Overall 1-year mortality was 43%, with 19% in-hospital mortality.
- Patients over 85 years old had a significantly poorer outcome (37% survival).
Conclusions:
- The predictive equation's performance was modest, indicating a need for refinement.
- The equation may assist in risk stratification for critically ill elderly patients.
- Outcomes for the oldest critically ill patients (over 85) remain a significant concern.
