Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention

BackgroundDue to increasing life expectancy and decreasing morbidity, society is aging. Especially the group of very old patients (≥90 years) is currently increasing significantly. This leads to increasing numbers of very old patients requiring visceral and thoracic surgery. However, due to the mult...

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Main Authors: Jöran Lücke, Franziska Stallbaum, Rikus Daniels, Pauline Theile, Jakob Izbicki, Anastasios D. Giannou, Stefan Wolter, Anna Duprée, Oliver Mann, Jakob Müller, Stefan Kluge, Matthias Reeh, Kevin Roedl
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Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1509337/full
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author Jöran Lücke
Jöran Lücke
Jöran Lücke
Franziska Stallbaum
Franziska Stallbaum
Franziska Stallbaum
Rikus Daniels
Pauline Theile
Jakob Izbicki
Anastasios D. Giannou
Anastasios D. Giannou
Anastasios D. Giannou
Stefan Wolter
Anna Duprée
Oliver Mann
Jakob Müller
Jakob Müller
Stefan Kluge
Matthias Reeh
Kevin Roedl
author_facet Jöran Lücke
Jöran Lücke
Jöran Lücke
Franziska Stallbaum
Franziska Stallbaum
Franziska Stallbaum
Rikus Daniels
Pauline Theile
Jakob Izbicki
Anastasios D. Giannou
Anastasios D. Giannou
Anastasios D. Giannou
Stefan Wolter
Anna Duprée
Oliver Mann
Jakob Müller
Jakob Müller
Stefan Kluge
Matthias Reeh
Kevin Roedl
author_sort Jöran Lücke
collection DOAJ
description BackgroundDue to increasing life expectancy and decreasing morbidity, society is aging. Especially the group of very old patients (≥90 years) is currently increasing significantly. This leads to increasing numbers of very old patients requiring visceral and thoracic surgery. However, due to the multimorbidity of this cohort, postoperative intensive care is often required. Currently, insufficient data are available regarding the treatment and therapy of very old surgical critically ill patients. Therefore, this study aimed to investigate factors associated with early postoperative mortality to identify patients at risk.MethodsA retrospective cohort study was performed using clinical and sociodemographic data of all very old patients admitted to the Department of Intensive Care Medicine after visceral or thoracic surgery at the University Medical Center Hamburg-Eppendorf, between January 2008 and April 2019. Univariate comparisons and multivariate regression analysis were performed to identify factors associated with early postoperative death.ResultsIn total, 84 patients were included in the analysis. In this cohort, 27 (32.14%) died within 28 days after admission to the intensive care unit (ICU). Comparisons between these two groups show no association between the specifics of the operative procedure with early postoperative death. However, the living situation before hospital admission was shown to be significantly different between those patients who survived and those who died early after postoperative care. We further show an association of early postoperative death with preexisting cardiac diseases, increased creatinine levels, and high Simplified Acute Physiology Score II (SAPS II) upon admission to ICU.ConclusionThe SAPS II score and creatinine level upon admission could be identified as predictors of survival and may be beneficial for risk stratification in the critically ill patient cohort of the very old.
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spelling doaj-art-1b4e373fd057450cb960bdf7c0ff18742025-08-20T02:28:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-05-011210.3389/fmed.2025.15093371509337Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical interventionJöran Lücke0Jöran Lücke1Jöran Lücke2Franziska Stallbaum3Franziska Stallbaum4Franziska Stallbaum5Rikus Daniels6Pauline Theile7Jakob Izbicki8Anastasios D. Giannou9Anastasios D. Giannou10Anastasios D. Giannou11Stefan Wolter12Anna Duprée13Oliver Mann14Jakob Müller15Jakob Müller16Stefan Kluge17Matthias Reeh18Kevin Roedl19Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanySection of Molecular Immunology and Gastroenterology, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyHamburg Center for Translational Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanySection of Molecular Immunology and Gastroenterology, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyHamburg Center for Translational Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanySection of Molecular Immunology and Gastroenterology, Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyHamburg Center for Translational Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Anesthesiology, Tabea Hospital, Hamburg, GermanyDepartment of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyDepartment of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyBackgroundDue to increasing life expectancy and decreasing morbidity, society is aging. Especially the group of very old patients (≥90 years) is currently increasing significantly. This leads to increasing numbers of very old patients requiring visceral and thoracic surgery. However, due to the multimorbidity of this cohort, postoperative intensive care is often required. Currently, insufficient data are available regarding the treatment and therapy of very old surgical critically ill patients. Therefore, this study aimed to investigate factors associated with early postoperative mortality to identify patients at risk.MethodsA retrospective cohort study was performed using clinical and sociodemographic data of all very old patients admitted to the Department of Intensive Care Medicine after visceral or thoracic surgery at the University Medical Center Hamburg-Eppendorf, between January 2008 and April 2019. Univariate comparisons and multivariate regression analysis were performed to identify factors associated with early postoperative death.ResultsIn total, 84 patients were included in the analysis. In this cohort, 27 (32.14%) died within 28 days after admission to the intensive care unit (ICU). Comparisons between these two groups show no association between the specifics of the operative procedure with early postoperative death. However, the living situation before hospital admission was shown to be significantly different between those patients who survived and those who died early after postoperative care. We further show an association of early postoperative death with preexisting cardiac diseases, increased creatinine levels, and high Simplified Acute Physiology Score II (SAPS II) upon admission to ICU.ConclusionThe SAPS II score and creatinine level upon admission could be identified as predictors of survival and may be beneficial for risk stratification in the critically ill patient cohort of the very old.https://www.frontiersin.org/articles/10.3389/fmed.2025.1509337/fullcritically illelderlyoldervery oldoutcomevisceral surgery
spellingShingle Jöran Lücke
Jöran Lücke
Jöran Lücke
Franziska Stallbaum
Franziska Stallbaum
Franziska Stallbaum
Rikus Daniels
Pauline Theile
Jakob Izbicki
Anastasios D. Giannou
Anastasios D. Giannou
Anastasios D. Giannou
Stefan Wolter
Anna Duprée
Oliver Mann
Jakob Müller
Jakob Müller
Stefan Kluge
Matthias Reeh
Kevin Roedl
Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
Frontiers in Medicine
critically ill
elderly
older
very old
outcome
visceral surgery
title Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
title_full Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
title_fullStr Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
title_full_unstemmed Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
title_short Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
title_sort clinical characteristics and outcome of very old ≥90 years critically ill patients with need for intensive care after surgical intervention
topic critically ill
elderly
older
very old
outcome
visceral surgery
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1509337/full
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