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Related Experiment Videos

Outcome prediction model for very elderly critically ill patients.

D M Nierman1, C B Schechter, L M Cannon

  • 1Department of Medicine, The Mount Sinai Medical Center, New York, NY, USA.

Critical Care Medicine
|October 6, 2001
PubMed
Summary

This study developed a prediction model for very elderly critically ill patients, identifying factors for hospital discharge or death. The model aids in discussing patient outcomes and planning care.

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Area of Science:

  • Critical care medicine
  • Geriatric medicine
  • Health outcomes research

Background:

  • Outcomes for critically ill elderly patients (≥85 years) are complex, including home discharge, skilled nursing facility discharge, or death.
  • Factors influencing these distinct outcomes remain largely unknown.

Purpose of the Study:

  • To develop a predictive model for three distinct hospital outcomes in critically ill elderly patients.
  • To identify key factors associated with patient disposition after intensive care unit (ICU) admission.

Main Methods:

  • Retrospective chart review and analysis of 455 patients aged 85 years or older admitted to ICUs in 1996-1997.
  • Ordinal logistic regression was used to develop and validate a predictive model.

Main Results:

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  • The final model incorporated age, gender, baseline support, ICU type, heart rate, mechanical ventilation, vasopressor use, pulmonary artery catheter use, and development of respiratory, neurologic, hematologic failure, or sepsis.
  • The model demonstrated good calibration and high discriminant index when validated on independent data.

Conclusions:

  • A validated mathematical model can predict the likelihood of home discharge, skilled nursing facility discharge, or death for very elderly critically ill patients.
  • These predictions can inform discussions about prognosis and goals of care, and assist in discharge planning.