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Alloveda Liver Update: Effect of old age on Critically Ill Patients with Cirrhosis

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eMediNexus    23 October 2020

Mounting evidence suggest that usually the prognosis of critically ill patients with cirrhosis is poor. The authors of the present study evaluated the effect of different age groups (< 65 years, 65–74 years, and ≥ 75 years) on the short- and medium-term outcomes of cirrhotic patients in the intensive-care-unit (ICU) setting. This cohort study comprised of 226 consecutive patients with liver cirrhosis who were admitted to the ICU. A comparison was made between the different age groups to evaluate the clinical outcomes, including ICU mortality, in-hospital mortality, ventilator-free days, ICU days, ICU-free days, hospital days, and hospital-free days.

The results declared that the overall ICU mortality in patients aged < 65 years, 65–74 years, and ≥ 75 years was reported to be 29.4%, 20.0%, and 30.3%, respectively. However, variation of age no significant difference in mortality or clinical outcomes in patients with compensated cirrhosis. Moreover, age ≥ 75 years was significantly associated with in-hospital mortality, 6-month mortality, hospital days, and hospital-free days in patients with decompensated cirrhosis. Besides, this age had significant in-hospital mortality (hazard ratio: 2.61) and 6-month mortality (hazard ratio: 2.34), while adjusting for sex, coronary artery disease, etiology of ICU admission, Acute Physiology and Chronic Health Evaluation II score, Model for End-Stage Liver Disease score, and mechanical ventilation.

Thus, the study concluded that variation in old age, during ICU stay, does not influence ICU mortality, ventilator-free days, ICU days, or ICU-free days in cirrhotic patients (both compensated and decompensated cirrhosis). However, age ≥ 75 years becomes an independent prognostic factor for in-hospital mortality and 6-month mortality in patients with decompensated cirrhosis after ICU discharge.

Source: Cheng-Yi C, Chih-Jen W, Chi-Feng P, Han-Hsiang C, Yu-Wei C. Influence of Age on Critically Ill Patients with Cirrhosis. International Journal of Gerontology. 2015 Dec;9(4):233-238.

 

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