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Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Erschienen in:

11.07.2023 | Reports of Original Investigations

Outcomes of critically ill older adults with COVID-19: a multicentre retrospective cohort study

verfasst von: Kiyan Heybati, BHSc, Eric K. C. Wong, MD, Jennifer Watt, MD, PhD, Hanyan Zou, BSc, Arthana Chandraraj, BSc, Alissa W. Zhang, BSc, Richard Norman, MD, Katrina Piggott, MD, Sharon E. Straus, MD, Barbara Liu, MD, Sangeeta Mehta, MD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 8/2023

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Abstract

Purpose

Older adults with COVID-19 have a high prevalence of complications and mortality during hospitalization. Given the large proportion of older adults requiring admission to an intensive care unit (ICU), we aimed to describe the management and outcomes of older adults with COVID-19 requiring ICU care and identify predictors of hospital mortality.

Methods

We included consecutive patients ≥ 65 yr of age who were admitted between 11 March 2020 and 30 June 2021 to one of five Toronto (ON, Canada) ICUs with a primary diagnosis of SARS-CoV-2 infection in a retrospective cohort study. Patient characteristics, ICU treatment, and outcomes were recorded. We used multivariable logistic regression to identify predictors of in-hospital mortality.

Results

Of the 273 patients, the median [interquartile range] age was 74 [69–80] yr, 104 (38.1%) were female, and 164 (60.1%) required invasive mechanical ventilation. One hundred and forty-two patients (52.0%) survived their hospital stay. Compared with survivors, nonsurvivors were older (74 [70–82] yr vs 73 [68–78] yr; P = 0.03), and a smaller proportion was female (39/131, 29.8% vs 65/142, 45.8%; P = 0.01). Patients had long hospital (19 [11–35] days) and ICU (9 [5–22] days) stays, with no significant differences in ICU length of stay or duration of invasive mechanical ventilation between the two groups. Higher APACHE II score, increasing age, and the need for organ support were independently associated with higher in-hospital mortality while female sex was associated with lower mortality.

Conclusions

Older critically ill COVID-19 patients had long ICU and hospital stays, and approximately half died in hospital. Further research is needed to identify individuals who will benefit most from an ICU admission and to evaluate posthospitalization outcomes.

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Titel: Outcomes of critically ill older adults with COVID-19: a multicentre retrospective cohort study
verfasst von: Kiyan Heybati, BHSc
Eric K. C. Wong, MD
Jennifer Watt, MD, PhD
Hanyan Zou, BSc
Arthana Chandraraj, BSc
Alissa W. Zhang, BSc
Richard Norman, MD
Katrina Piggott, MD
Sharon E. Straus, MD
Barbara Liu, MD
Sangeeta Mehta, MD
Publikationsdatum: 11.07.2023
Verlag: Springer International Publishing
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 8/2023
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-023-02518-y

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Outcomes of critically ill older adults with COVID-19: a multicentre retrospective cohort study