Scholarlink

<p>Although respiratory failure (RF) is frequent among older medical patients admitted to non-intensive hospital units, inherent data are scarce. We determined whether RF predicted adverse hospital outcomes independently of its causative illnesses. In a retrospective observational study from the Geriatric Risk Assessment and Care Evaluation database, we included 1093 patients consecutively admitted to a geriatric hospital unit (2022–2024). Study outcomes included hospital death, length of hospital stay (LOS) and post-discharge institutionalization (discharge to nursing homes or other long-term facilities). RF was diagnosed according to admission peripheral oxygen saturation ≤ 91%, or oxygen therapy/non-invasive ventilation during hospitalization, or specific diagnostic discharge codes. The predictive role of RF was investigated controlling for RF causative illnesses, frailty measured by the Multidimensional Prognostic Index (MPI), and C-reactive protein. The RF prevalence was 43%. Compared to controls, RF patients had higher hospital mortality (25.4% vs. 6.0%) and longer LOS, but comparable institutionalization rate. The fully adjusted odds ratio (OR) of RF for hospital mortality was 3.98 (95% Confidence Interval [CI] 2.53–6.28) and further increased after exclusion of 106 acute-on-chronic RF patients (4.71, CI 2.96–7.49). MPI, C-reactive protein, and sepsis emerged as additional significant predictors of mortality. RF also predicted longer LOS (F 6.78, p 0.009) in a linear regression model, along with age, MPI, pneumonia, pulmonary embolism, stroke, and sepsis. RF was highly prevalent and predicted hospital mortality and longer LOS <i>per se</i>, independently of its causative acute illnesses, frailty, and systemic inflammation. Older patients should be actively screened for RF during hospitalization.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Respiratory failure, underlying acute illnesses, and hospital outcomes: the S. Giovanni-Addolorata–SIGOT GRACE Study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月24日

查看全文
  • Filippo Luca Fimognari,
  • Angelo Scuteri,
  • Elena Del Giudice,
  • Francesco Baffa Bellucci,
  • Umberto Giuseppe Galasso,
  • Andrea Cavalli,
  • Mariagiovanna Cozza,
  • Elvira Clausi,
  • Lorenzo Palleschi,
  • Alba Rosa Alfano,
  • Raffaella Arnò,
  • Susanna Gaia Cannizzaro,
  • Moira Ceci,
  • Elena Del Giudice,
  • Giuseppe Umberto Galasso,
  • Maria Giuseppina Di Niro,
  • Lucia Puglisi,
  • Elia Salvatori,
  • Sonia Silvestrini,
  • Alessio Cuciniello,
  • Giulia Cifaldi,
  • Silvia Curinga,
  • Ilaria Bonucci,
  • Vincenzo Contino,
  • Daria Giovannini,
  • Teresa Iodice,
  • Mariagiovanna Cozza,
  • Francesca Crosta,
  • Carlo Custodero,
  • Ferdinando D’Amico,
  • Carlo De Matteis,
  • Vincenza Frisardi,
  • Maurizio Gallucci,
  • Gabriella Galluccio,
  • Klara Komici,
  • Ciro Manzo,
  • Federica Sganga,
  • Andrea Tumminia,
  • Liliana Mazza

摘要

Although respiratory failure (RF) is frequent among older medical patients admitted to non-intensive hospital units, inherent data are scarce. We determined whether RF predicted adverse hospital outcomes independently of its causative illnesses. In a retrospective observational study from the Geriatric Risk Assessment and Care Evaluation database, we included 1093 patients consecutively admitted to a geriatric hospital unit (2022–2024). Study outcomes included hospital death, length of hospital stay (LOS) and post-discharge institutionalization (discharge to nursing homes or other long-term facilities). RF was diagnosed according to admission peripheral oxygen saturation ≤ 91%, or oxygen therapy/non-invasive ventilation during hospitalization, or specific diagnostic discharge codes. The predictive role of RF was investigated controlling for RF causative illnesses, frailty measured by the Multidimensional Prognostic Index (MPI), and C-reactive protein. The RF prevalence was 43%. Compared to controls, RF patients had higher hospital mortality (25.4% vs. 6.0%) and longer LOS, but comparable institutionalization rate. The fully adjusted odds ratio (OR) of RF for hospital mortality was 3.98 (95% Confidence Interval [CI] 2.53–6.28) and further increased after exclusion of 106 acute-on-chronic RF patients (4.71, CI 2.96–7.49). MPI, C-reactive protein, and sepsis emerged as additional significant predictors of mortality. RF also predicted longer LOS (F 6.78, p 0.009) in a linear regression model, along with age, MPI, pneumonia, pulmonary embolism, stroke, and sepsis. RF was highly prevalent and predicted hospital mortality and longer LOS per se, independently of its causative acute illnesses, frailty, and systemic inflammation. Older patients should be actively screened for RF during hospitalization.