The aging of the population goes along with an increased demand for intensive care among very elderly patients (above 75-80 years old). At the same time, there is a decline in the supply of intensive care units (ICU). The 1-year mortality of patients above 80 years old in ICU ranged from 40 to 70%. Moreover, many survivors suffer from long-term sequelae as poor quality of life, cognitive impairment and functional disability. It is unclear under what conditions older patients may benefit from ICU admission. Cholangitis frequently occured in older patient. Moreover, severe acute cholangitis is a potentially life threatening disease characterized by a biliary obstruction and an infection of the bile possibly evolving towards systemic infection, shock and death. Because of its potential rapid reversibility of symptom thanks to early intravenous antibiotics and biliary decompression with drainage, old patients suffering from acute cholangitis are easily admitted to intensive care unit. To date, there is a lack of data about the outcome in this population admitted to the intensive care unit with acute cholangitis. The aim of the current study is to describe the outcomes in elderly patients (\> 75 years old) admitted to the ICU with acute cholangitis and to identify prognostics factors associated with long term mortality (6 months).
Study Type
OBSERVATIONAL
Enrollment
204
CHR Mercy
Metz, Lorraine, France
Emmanuel NOVY
Vandœuvre-lès-Nancy, Lorraine, France
mortality
rate of survivors and non survivors
Time frame: 180 days
mortality
rate of survivors and non survivors
Time frame: 90 days
mortality
rate of survivors and non survivors
Time frame: 28 days
factors associated with 6 months mortality (underlying condition)
Functional status : presence or absence of denutrition defined by a BMI \< 19 kg/m2 and/or albuminemia \< 30 g/l and/or loss of weight \> 5% during the last month (or \> 10% during the last three months)
Time frame: Day 1
factors associated with 6 months mortality (severity score)
Simplified Acute Physiology Score 2 Minimum value : 0 / Maximun value 163
Time frame: Day 1
factors associated with 6 months mortality (Presence of hemodynamic failure)
infusion of catecholamine (ie norepinephrine) during the ICU stay, yes or not
Time frame: Up to 7 days
factors associated with 6 months mortality (Presence of respiratory failure)
number of day(s) under mechanical ventilation
Time frame: Up to 7 days
factors associated with 6 months mortality (Presence of renal failure)
number od day(s) under renal replacement therapy
Time frame: Up to 7 days
Clinical evolution
Change in Sequential Organ Failure score between Day 1 and Day 3. We measured the Sepsis-related Organ Failure Assessment (SOFA) score at day and day 3 and then made the difference between the two scores the SOFA score could range between 0 and 24 We calculated the score at day 1 and day 3 and made the difference An absence or a small difference between the 2 days is associated with a worse outcome
Time frame: Day 3
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