Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based study
Abstract Background As the trajectory of very old critically-ill patients becomes an increasingly significant global challenge, these patients are often referred to intermediate care units. Intermediate care units provide a level of care that is less intensive than the intensive care unit (ICU) but...
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SpringerOpen
2025-05-01
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| Series: | Annals of Intensive Care |
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| Online Access: | https://doi.org/10.1186/s13613-025-01485-5 |
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| author | Adrien Migeon Arthur Kassa-Sombo Emeline Laurent Lucile Godillon Leslie Grammatico-Guillon Antoine Guillon |
| author_facet | Adrien Migeon Arthur Kassa-Sombo Emeline Laurent Lucile Godillon Leslie Grammatico-Guillon Antoine Guillon |
| author_sort | Adrien Migeon |
| collection | DOAJ |
| description | Abstract Background As the trajectory of very old critically-ill patients becomes an increasingly significant global challenge, these patients are often referred to intermediate care units. Intermediate care units provide a level of care that is less intensive than the intensive care unit (ICU) but more advanced than standard hospital wards. We aimed to assess the nationwide utilization of intermediate care units for critically ill patients aged 80 years or older (≥ 80 y.o.) and to examine their characteristics and long-term mortality outcomes. Methods From the overall adult population (aged 18 years and older) hospitalized in France (French Hospital Discharge Database) from January 1, 2014, to December 31, 2022, patients ≥ 80 y.o. were included. We examined trends in the utilization of medical intermediate care units for critically ill patients ≥ 80 y.o and reported patient characteristics, including the Charlson comorbidity index and Hospital Frailty Risk Score. Readmission rates (hospital or rehabilitation unit) and mortality rates were calculated during a one-year follow-up period after the end of hospital stay. Results The proportion of patients ≥ 80 y.o. in intermediate care units was 31% whereas it was 17% in ICU. Patients with greater comorbidities and severity were more frequently hospitalized in polyvalent intermediate care units (10% of them receiving acute organ support) compared to specialized intermediate care units. Admission to intermediate care units was associated with a 14% mortality rate during the stay, 28% at one year. Additionally, 58% of intermediate care units patients were rehospitalized within the year following discharge (6% in critical care units). Conclusions One-third of the patients hospitalized in the intermediate care units in France are aged 80 years or older. |
| format | Article |
| id | doaj-art-e4288808e9244ffbbae6e830bea183c1 |
| institution | OA Journals |
| issn | 2110-5820 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj-art-e4288808e9244ffbbae6e830bea183c12025-08-20T02:00:08ZengSpringerOpenAnnals of Intensive Care2110-58202025-05-0115111010.1186/s13613-025-01485-5Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based studyAdrien Migeon0Arthur Kassa-Sombo1Emeline Laurent2Lucile Godillon3Leslie Grammatico-Guillon4Antoine Guillon5Department of Geriatrics, Tours University HospitalResearch Center for Respiratory Diseases (CEPR), INSERM U1100, University of ToursEpidemiology Unit EpiDcliC, Clinical Data Center, Service of Public Health, Tours University HospitalEpidemiology Unit EpiDcliC, Clinical Data Center, Service of Public Health, Tours University HospitalEpidemiology Unit EpiDcliC, Clinical Data Center, Service of Public Health, Tours University HospitalResearch Center for Respiratory Diseases (CEPR), INSERM U1100, University of ToursAbstract Background As the trajectory of very old critically-ill patients becomes an increasingly significant global challenge, these patients are often referred to intermediate care units. Intermediate care units provide a level of care that is less intensive than the intensive care unit (ICU) but more advanced than standard hospital wards. We aimed to assess the nationwide utilization of intermediate care units for critically ill patients aged 80 years or older (≥ 80 y.o.) and to examine their characteristics and long-term mortality outcomes. Methods From the overall adult population (aged 18 years and older) hospitalized in France (French Hospital Discharge Database) from January 1, 2014, to December 31, 2022, patients ≥ 80 y.o. were included. We examined trends in the utilization of medical intermediate care units for critically ill patients ≥ 80 y.o and reported patient characteristics, including the Charlson comorbidity index and Hospital Frailty Risk Score. Readmission rates (hospital or rehabilitation unit) and mortality rates were calculated during a one-year follow-up period after the end of hospital stay. Results The proportion of patients ≥ 80 y.o. in intermediate care units was 31% whereas it was 17% in ICU. Patients with greater comorbidities and severity were more frequently hospitalized in polyvalent intermediate care units (10% of them receiving acute organ support) compared to specialized intermediate care units. Admission to intermediate care units was associated with a 14% mortality rate during the stay, 28% at one year. Additionally, 58% of intermediate care units patients were rehospitalized within the year following discharge (6% in critical care units). Conclusions One-third of the patients hospitalized in the intermediate care units in France are aged 80 years or older.https://doi.org/10.1186/s13613-025-01485-5Critical careIntensive care unitIntermediate care unitsOld patientsLong-term mortality |
| spellingShingle | Adrien Migeon Arthur Kassa-Sombo Emeline Laurent Lucile Godillon Leslie Grammatico-Guillon Antoine Guillon Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based study Annals of Intensive Care Critical care Intensive care unit Intermediate care units Old patients Long-term mortality |
| title | Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based study |
| title_full | Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based study |
| title_fullStr | Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based study |
| title_full_unstemmed | Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based study |
| title_short | Hospitalization of very old critically ill patients in medical intermediate care units in France: a nationwide population-based study |
| title_sort | hospitalization of very old critically ill patients in medical intermediate care units in france a nationwide population based study |
| topic | Critical care Intensive care unit Intermediate care units Old patients Long-term mortality |
| url | https://doi.org/10.1186/s13613-025-01485-5 |
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