TY - JOUR
T1 - Functional outcome after critical illness in older patients
T2 - a population-based study
AU - Hajeb, Mania
AU - Singh, Tarun D.
AU - Sakusic, Amra
AU - Graff-Radford, Jonathan
AU - Gajic, Ognjen
AU - Rabinstein, Alejandro A.
N1 - Funding Information:
This study was made possible, in part, by funding from the National Institute of Aging (U01 AG006786, P50 AG16574, and R01 AG034676).
Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Purpose: To determine the prevalence of disability among ICU survivors one year after admission, and which factors influence functional outcome. Methods: We examined consecutive patients enrolled in the population-based Mayo Clinic Olmsted Study of Aging and then admitted to medical or surgical adult ICUs at Mayo Clinic, Rochester between January 1, 2006, and December 31, 2014 to determine one-year functional outcomes. Results: 831cases were included. Mean age was 84 years (IQR 79–88). 569 (68.5%) patients were alive one year after ICU admission. Of them, 546 patients had functional assessment at one year and 367 (67.2%) had good functional outcome. On multivariable analysis, poor one-year functional outcome (death or disability) was more common among women, older patients, and patients with baseline cognitive impairment (mild cognitive impairment or dementia), higher Carlson scores, and longer ICU stay (all P <.01). After excluding deceased patients, these associations remained unchanged. In addition, 120 (32.3%) of 372 patients who had post-ICU cognitive evaluation experienced cognitive decline after the ICU admission. Conclusions: On a population-based cohort of older, predominantly elderly patients, approximately two-thirds of survivors maintained or regained good functional status 1 year after ICU hospitalization. However, older age, female sex, greater comorbidities, abnormal baseline cognition, and longer ICU stay were associated with poor functional recovery and cognitive decline was common.
AB - Purpose: To determine the prevalence of disability among ICU survivors one year after admission, and which factors influence functional outcome. Methods: We examined consecutive patients enrolled in the population-based Mayo Clinic Olmsted Study of Aging and then admitted to medical or surgical adult ICUs at Mayo Clinic, Rochester between January 1, 2006, and December 31, 2014 to determine one-year functional outcomes. Results: 831cases were included. Mean age was 84 years (IQR 79–88). 569 (68.5%) patients were alive one year after ICU admission. Of them, 546 patients had functional assessment at one year and 367 (67.2%) had good functional outcome. On multivariable analysis, poor one-year functional outcome (death or disability) was more common among women, older patients, and patients with baseline cognitive impairment (mild cognitive impairment or dementia), higher Carlson scores, and longer ICU stay (all P <.01). After excluding deceased patients, these associations remained unchanged. In addition, 120 (32.3%) of 372 patients who had post-ICU cognitive evaluation experienced cognitive decline after the ICU admission. Conclusions: On a population-based cohort of older, predominantly elderly patients, approximately two-thirds of survivors maintained or regained good functional status 1 year after ICU hospitalization. However, older age, female sex, greater comorbidities, abnormal baseline cognition, and longer ICU stay were associated with poor functional recovery and cognitive decline was common.
KW - Older adults
KW - cognitive impairment
KW - critical illness
KW - disability
KW - functional outcome
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U2 - 10.1080/01616412.2020.1831302
DO - 10.1080/01616412.2020.1831302
M3 - Article
C2 - 33012281
AN - SCOPUS:85092447914
SN - 0161-6412
VL - 43
SP - 103
EP - 109
JO - Neurological Research
JF - Neurological Research
IS - 2
ER -