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Older Patients' Mortality Risk After ICU Treatment Assessed

Hospitalized Medicare patients have higher three-year risk if they've had intensive care during stay

TUESDAY, March 2 (HealthDay News) -- Older patients who receive intensive care during a hospital stay may have an elevated risk of death in the three years after hospital discharge, with risk increasing substantially among patients who require mechanical ventilation, according to research published in the March 3 issue of the Journal of the American Medical Association.

Hannah Wunsch, M.D., of Columbia University in New York City, and colleagues analyzed data from 35,308 Medicare beneficiaries who survived a hospital stay in 2003 in which they received intensive care. This group was matched with a control group of Medicare beneficiaries who survived hospitalization without intensive care and another group from the general Medicare population. The main outcome was three-year mortality after discharge.

The researchers found that intensive care unit survivors had higher mortality compared to hospital and general controls (39.5 versus 34.5 and 14.9 percent, respectively). However, intensive care unit survivors who didn't receive mechanical ventilation only had a slightly increased risk of three-year mortality compared to hospital controls (adjusted hazard ratio, 1.04). Those who received mechanical ventilation had higher mortality (adjusted hazard ratio, 1.56), with much of the risk found in the six months following the quarter in which they were discharged.

"Approximately 1.4 million elderly Medicare beneficiaries are discharged alive each year from hospitals in the United States after receiving intensive care. Among this elderly cohort, with an average age of 78 years, the need for intensive care confers an increased risk of mortality after discharge from the hospital, mostly attributable to patients who require mechanical ventilation," the authors write.

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