記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: This study aimed to elucidate the age trends among non-surgical patients requiring intensive care over a 10-year period and the prognostic impact of aging in relation to their underlying etiologies. METHODS AND RESULTS: In all, 4,279 non-surgical patients requiring intensive care from 2012 to 2021 were enrolled in the study. Patient backgrounds and prognoses were compared among age 4 groups: Group A, age <60 years (n=910); Group B, age 60-69 years (n=1,062); Group C, age 70-79 years (n=1,355); and Group D, age ≥80 years (n=952). During the study period, the number of patients aged 60-69 years decreased significantly with time, whereas the number aged over 80 years increased significantly. A multivariate Cox regression model identified Group D as an independent predictor of 365-day all-cause mortality (hazard ratio [HR] 2.070; 95% confidence interval [CI] 1.619-2.646) relative to Group A. Multivariate logistic regression analysis indicated that the presence of sepsis was independently associated with 365-day mortality, especially in the cohort aged ≥80 years (HR 1.878; 95% CI 1.270-2.777; P=0.002). CONCLUSIONS: The mean age of patients requiring non-surgical intensive care is increasing annually, and greater age was identified as a significant factor associated with a higher 365-day mortality rate. The presence of sepsis was linked to increased 365-day mortality among older individuals.

DOI： 10.1253/circj.CJ-24-1030

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The aim of the present study is to elucidate prognostic impact of temporal trends of non-surgical patients requiring intensive care over a 10-year period. METHODS AND RESULTS: A total of 4276 non-surgical patients requiring intensive care from 2012 to 2021 were enrolled. Patients' backgrounds, in-hospital management, and prognoses were compared between five groups [2012-2013 (n = 825), 2014-2015 (n = 784), 2016-2017 (n = 864), 2018-2019 (n = 939), and 2020-2021 (n = 867)]. During the study period, mean age significantly increased from 69 years in 2012-2013 to 72 years in 2020-2021. Mean Acute Physiology and Chronic Health Evaluation scores significantly increased from 10 points in 2012-2013 to 12 points in 2020-2021. The median duration of intensive care unit stays increased from 3 to 4 days. Kaplan-Meier survival curve analysis showed that survival rates during 30- and 365-days were significantly lower in 2020-2021 than in 2012-2013, but it was not significantly different by a Cox proportional hazards regression model in 30 days. A Cox proportional hazards regression model revealed that the risks of 365-day all-cause death were significantly higher in patients enrolled in 2016-2017 (HR: 1.324, 95 % CI: 1.042-1.680, p = 0.021), in 2018-2019 (HR: 1.329, 95 % CI: 1.044-1.691, p = 0.021), and in 2020-2021 (HR: 1.409, 95 % CI: 1.115-1.779, p = 0.004). CONCLUSION: The condition of patients requiring intensive care is becoming more critical year by year, leading to poorer long-term prognoses despite improvements in treatment strategies. These findings emphasize the importance of additional care management after admission into non-surgical intensive care units, particularly for the aging society of Japan.

DOI： 10.1016/j.jjcc.2024.06.003

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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