Cost analysis of the very elderly admitted to intensive care units

Critical Care : the Official Journal of the Critical Care Forum
Nicolas Chin-YeeKwadwo Kyeremanteng

Abstract

Very elderly patients are often admitted to intensive care units (ICUs) despite poor outcomes and frequent preference to avoid unnecessary prolongation of life. We sought to determine the cost of ICU admission for the very elderly and the factors influencing this cost. This prospective, observational cohort study included patients ≥80 years old admitted to 22 Canadian ICUs from 2009 to 2013. A subset of consenting individuals comprised a longitudinal cohort followed over 12 months. Costs were calculated from ICU length of stay and unit costs for ICU admission from a Canadian academic hospital. A generalized linear model was employed to identify cost-predictive variables. In total, 1671 patients were included; 610 were enrolled in the longitudinal cohort. The average age was 85 years; median ICU length of stay was 4 days. Mortality was 35% (585/1671) in hospital and 41% (253/610) at 12 months. The average cost of ICU admission per patient was $31,679 ± 65,867. Estimated ICU costs were $48,744 per survivor to discharge and $61,783 per survivor at 1 year. For both decedents and survivors, preference for comfort measures over life support was an independent predictor for lower cost (P < 0.01). Considering the poor clinical outcomes...Continue Reading

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Citations

Feb 7, 2018·Critical Care Medicine·Shannon M FernandoKwadwo Kyeremanteng
May 29, 2019·Critical Care Medicine·Shannon M FernandoKwadwo Kyeremanteng
Jan 24, 2018·Journal of Intensive Care Medicine·Shannon M FernandoKwadwo Kyeremanteng
Jun 28, 2020·Journal of the American Geriatrics Society·Lenneke E M HaasNicolette F de Keizer
Jul 7, 2018·Critical Care : the Official Journal of the Critical Care Forum·Youfeng ZhuJianrui Wei
Sep 25, 2018·Critical Care Research and Practice·Peter M ReardonKwadwo Kyeremanteng
Jul 8, 2017·Critical Care : the Official Journal of the Critical Care Forum·Christopher Bassford
Nov 28, 2018·Annals of Intensive Care·Bertrand GuidetHans Flaatten
Jul 7, 2018·Critical Care : the Official Journal of the Critical Care Forum·Shannon M FernandoKwadwo Kyeremanteng
Sep 27, 2018·Intensive Care Medicine·L E M HaasNicolette F de Keizer
Jan 2, 2021·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Florian B MayrSachin Yende
Dec 31, 2020·Journal of Clinical Medicine·Aileen HillChristian Stoppe
Feb 18, 2021·Critical Care Nursing Quarterly·Marina Grabda, Fidelindo A Lim
Dec 8, 2021·BMC Health Services Research·Claudia DziegielewskiKwadwo Kyeremanteng

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