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Cumulative prognostic score predicting mortality in patients older than 80 years admitted to the ICU

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Abstract
OBJECTIVES: To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN Prospective cohort study. SETTING: A total of 306 ICUs from 24 European countries. PARTICIPANTS: Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81-87 y]; 51.8% male). MEASUREMENTS: Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30-day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves. RESULTS: The 30-day-mortality was 1562 (41.9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis, Clinical Frailty Scale, Sequential Organ Failure Score, invasive mechanical ventilation, and renal replacement therapy. The discrimination, accuracy, and calibration of the model were good: the area under the curve for a score of 10 or higher was .80, and the Brier score was .18. At a cut point of 10 or higher (75% of all patients), the model predicts 30-day mortality in 91.1% of all patients who die. CONCLUSION: A predictive model of cumulative events predicts 30-day mortality in patients older than 80 years admitted to ICUs. Future studies should include other potential predictor variables including functional status, presence of advance care plans, and assessment of each patient's decision-making capacity.
Keywords
critical care, prognosis, older adults, predict, model, INTENSIVE-CARE-UNIT, ILL ELDERLY-PATIENTS, DECISION-MAKING, PHYSICIANS, ADMISSION

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MLA
Lange, Dylan W., et al. “Cumulative Prognostic Score Predicting Mortality in Patients Older than 80 Years Admitted to the ICU.” JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, vol. 67, no. 6, 2019, pp. 1263–67.
APA
Lange, D. W., Brinkman, S., Flaatten, H., Boumendil, A., Morandi, A., Andersen, F. H., … Guidet, B. (2019). Cumulative prognostic score predicting mortality in patients older than 80 years admitted to the ICU. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 67(6), 1263–1267.
Chicago author-date
Lange, Dylan W, Sylvia Brinkman, Hans Flaatten, Ariane Boumendil, Alessandro Morandi, Finn H Andersen, Antonio Artigas, et al. 2019. “Cumulative Prognostic Score Predicting Mortality in Patients Older than 80 Years Admitted to the ICU.” JOURNAL OF THE AMERICAN GERIATRICS SOCIETY 67 (6): 1263–67.
Chicago author-date (all authors)
Lange, Dylan W, Sylvia Brinkman, Hans Flaatten, Ariane Boumendil, Alessandro Morandi, Finn H Andersen, Antonio Artigas, Guido Bertolini, Maurizio Cecconi, Steffen Christensen, Loredana Faraldi, Jesper Fjølner, Christian Jung, Brian Marsh, Rui Moreno, Sandra Oeyen, Christina Agvald Öhman, Bernadro Bollen Pinto, Anne Marie GA Smet, Ivo W Soliman, Wojciech Szczeklik, Andreas Valentin, Ximena Watson, Tilemachos Zafeiridis, and Bertrand Guidet. 2019. “Cumulative Prognostic Score Predicting Mortality in Patients Older than 80 Years Admitted to the ICU.” JOURNAL OF THE AMERICAN GERIATRICS SOCIETY 67 (6): 1263–1267.
Vancouver
1.
Lange DW, Brinkman S, Flaatten H, Boumendil A, Morandi A, Andersen FH, et al. Cumulative prognostic score predicting mortality in patients older than 80 years admitted to the ICU. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY. 2019;67(6):1263–7.
IEEE
[1]
D. W. Lange et al., “Cumulative prognostic score predicting mortality in patients older than 80 years admitted to the ICU,” JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, vol. 67, no. 6, pp. 1263–1267, 2019.
@article{8613417,
  abstract     = {OBJECTIVES: To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN Prospective cohort study.
SETTING: A total of 306 ICUs from 24 European countries.
PARTICIPANTS: Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81-87 y]; 51.8% male).
MEASUREMENTS: Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30-day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteristic curves.
RESULTS: The 30-day-mortality was 1562 (41.9%). In multivariable analysis, these variables were selected as independent predictors of mortality: age, sex, ICU admission diagnosis, Clinical Frailty Scale, Sequential Organ Failure Score, invasive mechanical ventilation, and renal replacement therapy. The discrimination, accuracy, and calibration of the model were good: the area under the curve for a score of 10 or higher was .80, and the Brier score was .18. At a cut point of 10 or higher (75% of all patients), the model predicts 30-day mortality in 91.1% of all patients who die.
CONCLUSION: A predictive model of cumulative events predicts 30-day mortality in patients older than 80 years admitted to ICUs. Future studies should include other potential predictor variables including functional status, presence of advance care plans, and assessment of each patient's decision-making capacity.},
  author       = {Lange, Dylan W and Brinkman, Sylvia and Flaatten, Hans and Boumendil, Ariane and Morandi, Alessandro and Andersen, Finn H and Artigas, Antonio and Bertolini, Guido and Cecconi, Maurizio and Christensen, Steffen and Faraldi, Loredana and Fjølner, Jesper and Jung, Christian and Marsh, Brian and Moreno, Rui and Oeyen, Sandra and Öhman, Christina Agvald and Bollen Pinto, Bernadro and Smet, Anne Marie GA and Soliman, Ivo W and Szczeklik, Wojciech and Valentin, Andreas and Watson, Ximena and Zafeiridis, Tilemachos and Guidet, Bertrand},
  issn         = {0002-8614},
  journal      = {JOURNAL OF THE AMERICAN GERIATRICS SOCIETY},
  keywords     = {critical care,prognosis,older adults,predict,model,INTENSIVE-CARE-UNIT,ILL ELDERLY-PATIENTS,DECISION-MAKING,PHYSICIANS,ADMISSION},
  language     = {eng},
  number       = {6},
  pages        = {1263--1267},
  title        = {Cumulative prognostic score predicting mortality in patients older than 80 years admitted to the ICU},
  url          = {http://dx.doi.org/10.1111/jgs.15888},
  volume       = {67},
  year         = {2019},
}

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