Understanding how preexisting comorbidities may interact with a critical illness is important for the assessment of long-term survival probability of older patients admitted to the ICU. The mortality after a first ICU admission in patients ≥ 55 years old registered in the Swedish Intensive Care Registry was compared to age- and sex-matched individuals from the general population with a landmark after 1 year. The comparison was adjusted for age, sex, and baseline comorbidity using Cox regression. The 7-year study period included 140 008 patients, of whom 23% were 80 years or older. Patients surviving the first year remained at an increased risk compared to the general population, but much of this difference was attenuated after adjustment for baseline comorbidity (HR, 1.03; 95% CI 1.02–1.04). Excluding cardio-thoracic ICU admissions, the increased risk remained slightly elevated (adjusted HR, 1.15; 95% CI 1.13–1.16). Also, the subgroup ≥ 75 years old surviving the first year returned to a mortality rate comparable to the general population (HR, 0.98; 95% CI 0.96–0.99). Stratified by admission diagnosis an increased mortality rate remained beyond the first year for acute-on-chronic respiratory failure (adjusted HR, 1.47; 95% CI 1.36–1.58) but not for other respiratory causes (adjusted HR, 1.03; 95% CI 0.99–1.07) or admission for septic shock (adjusted HR, 1.04; 95% CI 0.95–1.13). No substantial increased mortality rate was notable beyond the first year for other admission diagnoses. Older ICU patients that survive the first year after an ICU admission return to a mortality rate close to that of the general population having similar baseline comorbidity, but variability is seen depending on the ICU admission diagnosis. Trial registration ClinicalTrials.gov ID: NCT06234709, date 02/01/2024.

中文翻译：

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与一般人群相比，老年 ICU 患者的长期条件死亡率


了解先前存在的合并症如何与危重疾病相互作用，对于评估入住 ICU 的老年患者的长期生存概率非常重要。将瑞典重症监护登记处登记的 55 ≥患者首次入住 ICU 后的死亡率与来自 1 年后具有里程碑意义的普通人群的年龄和性别匹配的个体进行了比较。使用 Cox 回归调整年龄、性别和基线合并症的比较。7 年研究期包括 140 008 名患者，其中 23% 的患者年龄在 80 岁或以上。与一般人群相比，第一年存活的患者风险仍然增加，但在调整基线合并症后，这种差异的大部分减弱了 （HR，1.03;95% CI 1.02-1.04）。不包括心胸 ICU 收治，增加的风险仍然略有升高（校正 HR，1.15;95% CI 1.13-1.16）。此外，第一年存活≥ 75 岁的亚组死亡率恢复为与一般人群相当 （HR， 0.98;95% CI 0.96–0.99）。按入院诊断分层，慢加急性呼吸衰竭（校正 HR，1.47;95% CI 1.36-1.58）死亡率在第一年后仍然增加，但其他呼吸原因（校正 HR，1.03;95% CI 0.99-1.07）或感染性休克入院（校正 HR，1.04;95% CI 0.95-1.13）的死亡率增加。其他入院诊断在第一年之后死亡率没有显着显着增加。入住 ICU 后第一年存活的老年 ICU 患者的死亡率接近具有相似基线合并症的一般人群，但根据 ICU 收治诊断存在差异。试验注册 ClinicalTrials.政府 ID：NCT06234709，日期 2024 年 2 月 1 日。