PMID- 36743703
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230207
IS  - 2645-4904 (Electronic)
IS  - 2645-4904 (Linking)
VI  - 11
IP  - 1
DP  - 2023
TI  - Associated Factors of In-hospital Mortality among Intubated Older Adults in 
      Emergency Department; a Cross-sectional Study.
PG  - e16
LID - 10.22037/aaem.v11i1.1613 [doi]
LID - e16
AB  - INTRODUCTION: A decision-making guideline on when to intubate an older person 
      based on predictors of intubation outcome would be extremely beneficial. This 
      study aimed to identify the associated factors that could predict the outcomes of 
      endotracheal intubation among older adults in the Emergency Department (ED). 
      METHODS: In this retrospective cross-sectional study, patients aged >/=65 years 
      intubated at the ED of University of Malaya Medical Centre, Kuala Lumpur, 
      Malaysia, from 2015 to 2019 were studied. The association between age, gender, 
      place of inhabitation, Identification of Seniors at Risk (ISAR) score for 
      frailty, Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health 
      Evaluation-II (APACHE-II) score, indication for intubation, and diagnosis on 
      admission with in-hospital mortality (primary outcome) and duration of 
      ventilation, and length of stay (secondary outcomes) were evaluated using 
      univariate analysis and Cox's regression survival analysis. RESULTS: 889 cases 
      aged 65 years and above were studied (61.5% male). The rate of in-hospital 
      mortality was 71.4%. There was a significant association between age (p < 0.001), 
      nursing home residency (p = 0.008), CCI>/= 5 (p = 0.001), APACHE-II (p < 0.001), 
      pre-intubation Glasgow Coma Scale (GCS) (p < 0.001), cardiac arrest as indication 
      of intubation (p < 0.001), diagnosis on admission (p < 0.001), length of stay (p 
      < 0.001), and length of ventilation (p = 0.003) and in-hospital mortality. Age >/= 
      85 years (HR= 1.270; 95%CI=1.074 to 1.502) and 75 to 84 years (HR=1.642; 
      95%CI=1.167 to 2.076), cardiac arrest as indication of intubation (HR: 1.882; 95% 
      CI: 1.554 - 2.279), and APACHE-II scores 25 - 34 (HR: 1.423; 95% CI: 1.171 - 
      1.730) and >/= 35 (HR: 1.789; 95%CI: 1.418 - 2.256) were amongst the independent 
      predictive factors of in-hospital mortality. CONCLUSION: Nearly three out of four 
      individuals aged >/=65 years intubated at the ED died during the same admission. 
      Older age, cardiac arrest as indication of intubation, and APACHE-II score were 
      independent predictors of in-hospital mortality.
FAU - Idzwan Zakaria, Mohd
AU  - Idzwan Zakaria M
AD  - Academic Trauma and Emergency Unit, Faculty of Medicine, University of Malaya, 
      Kuala Lumpur, Malaysia.
FAU - Che Manshor, Norhadila
AU  - Che Manshor N
AD  - Academic Trauma and Emergency Unit, Faculty of Medicine, University of Malaya, 
      Kuala Lumpur, Malaysia.
FAU - Maw Pin, Tan
AU  - Maw Pin T
AD  - Geriatric Unit, Department of Medicine, Faculty of Medicine, University of 
      Malaya, Kuala Lumpur, Malaysia.
LA  - eng
PT  - Journal Article
DEP - 20230103
PL  - Iran
TA  - Arch Acad Emerg Med
JT  - Archives of academic emergency medicine
JID - 101740147
PMC - PMC9887227
OTO - NOTNLM
OT  - Aged
OT  - Artificial
OT  - Respiration
OT  - emergency service
OT  - hospital
OT  - intubation
COIS- None declared
EDAT- 2023/02/07 06:00
MHDA- 2023/02/07 06:01
PMCR- 2023/01/03
CRDT- 2023/02/06 03:59
PHST- 2023/02/06 03:59 [entrez]
PHST- 2023/02/07 06:00 [pubmed]
PHST- 2023/02/07 06:01 [medline]
PHST- 2023/01/03 00:00 [pmc-release]
AID - 10.22037/aaem.v11i1.1613 [doi]
PST - epublish
SO  - Arch Acad Emerg Med. 2023 Jan 3;11(1):e16. doi: 10.22037/aaem.v11i1.1613. 
      eCollection 2023.