Predictors of adverse outcomes in aged patients critically ill with COVID-19: a retrospective study

Matthew Rockstrom; Eric Balaban; Shoaib Fakhri; Ryan A Peterson; Ying Jin; Sarah E Jolley; Kristine M Erlandson; Joseph A Hippensteel

doi:10.1177/10815589221150644

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Predictors of adverse outcomes in aged patients critically ill with COVID-19: a retrospective study

Journal article

Peer reviewed

Predictors of adverse outcomes in aged patients critically ill with COVID-19: a retrospective study

Matthew Rockstrom, Eric Balaban, Shoaib Fakhri, Ryan A Peterson, Ying Jin, Sarah E Jolley, Kristine M Erlandson and Joseph A Hippensteel

Journal of investigative medicine, Vol.71(4), pp.315-320

04/01/2023

DOI: 10.1177/10815589221150644

PMCID: PMC9902787

PMID: 36655809

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https://pmc.ncbi.nlm.nih.gov/articles/PMC9902787/pdf/10.1177_10815589221150644.pdfView

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Abstract

Older patients represent an inordinate proportion of intensive care unit (ICU) admissions and ICU mortality associated with coronavirus disease 2019 (COVID-19). In this retrospective cohort study, we examine 198 patients, aged 18 years or older, admitted to the ICU from March to June 2020. We aim to understand the relationships between age, number of comorbidities, and independent living prior to admission on outcomes of mortality, length of stay, renal failure, respiratory failure, and shock. In this cohort, we find that overall mortality was associated with respiratory failure severity (for every decrease of P:F by 50, odds ratio (OR) 2.98 (1.65-6.08)), acute renal failure (OR 4.61 (1.2-19.7)), and age 65 or greater (OR: 3.7 (1.86-7.36)). Surprisingly, increasing age was associated with less severe respiratory failure (R = 0.22, p < 0.01). When adjusting for pre-existing chronic kidney disease, age was not associated with development of acute kidney injury (OR: 1.01 (0.99-1.03)). While chronologic age is associated with mortality, it is not associated independently with severe end organ damage. This is consistent with growing evidence suggesting that a complex interplay between multimorbidity, immunosenescence, and physiologic age is primarily responsible for the vulnerability to COVID-19.

Acute Kidney Injury

COVID-19

Critical Illness

Hospital Mortality

Humans

Respiratory Insufficiency - complications

Retrospective Studies

SARS-CoV-2

Details

Title: Subtitle: Predictors of adverse outcomes in aged patients critically ill with COVID-19: a retrospective study
Creators: Matthew Rockstrom - University of Colorado Anschutz Medical Campus
Eric Balaban - Division of Hospital Medicine, Department of Medicine, University of Pittsburg Medical Center, Pittsburgh, PA, USA
Shoaib Fakhri - Pittsburg State University
Ryan A Peterson - Colorado School of Public Health
Ying Jin - Colorado School of Public Health
Sarah E Jolley - University of Colorado Anschutz Medical Campus
Kristine M Erlandson - University of Colorado Anschutz Medical Campus
Joseph A Hippensteel - University of Colorado Anschutz Medical Campus
Resource Type: Journal article
Publication Details: Journal of investigative medicine, Vol.71(4), pp.315-320
DOI: 10.1177/10815589221150644
PMID: 36655809
PMCID: PMC9902787
NLM abbreviation: J Investig Med
ISSN: 1081-5589
eISSN: 1708-8267
Grant note: R01 AG054366 / NIA NIH HHS K08 HL159353 / NHLBI NIH HHS R03 AG074056 / NIA NIH HHS UL1 TR002535 / NCATS NIH HHS
Language: English
Date published: 04/01/2023
Academic Unit: Biostatistics; Internal Medicine
Record Identifier: 9984914021602771

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