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predicors of icu outcome .doc

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predicors of geriatric icu outcome
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  Admission predictors of mortality in Geriatrics intensive care Authors:Mahmoud A. Refaee , MD 1 , and Doha Rasheedy, MD 1 . 1 Lecturer of Geriatrics; Geriatrics and Gerontology Department; Faculty of Medicine, Ain shams university, Cairo, EgyptCorresponding Author! Doha Rasheedy,  MD,Geriatrics department Ain hams#niversity Cairo, Egypt$hone! %&'1''11()*++E mail! doharashidyyahoocomCoauthors! Mahmoud A. Refaee ! MD,Geriatrics department Ain hams#niversity Cairo, EgyptE mail! stri-earro.&'1'hotmailcomFunding/he author0s received no financial support for the research and2or authorship of this article /he authors declare   that!All named authors have seen and approved the final version of the manuscript/he manuscript, or part of it, has never 3een pu3lished nor is currently under consideration for pu3lication 3y any other 4ournalAuthors5 contri3utions! 6oth authors e7ually contri3uted in study design, ac7uisition, analysis and interpretation of data and revised the manuscript, drafted the article, Gave final approval of the version to 3e pu3lished  Admission predictors of mortality in Geriatrics intensive care Abstract: 6ac-ground!Elderly patients are a significant and increasing proportion of 8C# patients 9ithadvancing age, the comor3idities critically ill elderly patients have su3stantialmortality /he early recognition of patients at high ris- of mortality is needed to plancare in advance and to control healthcare costsAim!   /o find out the admission clinical and la3oratory predictors of mortality in criticallyill elderly admitted to 8C#   Method!A prospective study .as performed in Geriatric 8C# in Ain hams #niversity:ospitals including (' critically ill elderly patients admitted for &+ hours or moreEach patient .as su34ected to on admission clinical assessment, in addition tola3oratory investigations including; measurement of serum levels of 6lood urea itrogen, Creatinine, odium, $otassium, Calcium, $hosphorus, Magnesium, <inc,6iliru3in, Complete 3lood count 0C6C, C=$ and arterial 3lood gases=esults!Mortality accounted for )(> of patient5s outcome Advanced age .as significantlyassociated .ith increased mortality 0p?'')/he acute stro-e as a cause of admission .as found to 3e associated .ith increasedmortality 0$? ''' Length of 8C# stay and the use of mechanical ventilationsignificantly increased mortality 0$? ''1, $ ? '''' respectively  /achycardia, tachypnea and deep coma .ere also found to 3e associated .ithincreased mortality 0$? '''), ''&, '''' respectively :ematocrit, 3icar3onate, andsodium levels .ere significantly lo.er among the non survivorsConclusions!/he most important factors independently associated .ith the high ris- of mortalityamong elderly admitted in 8C# are; advanced age, impaired level of consciousness,need for mechanical ventilation, lo. serum sodium and 3icar3onate levels Earlymanagement of hyponatremia and meta3olic acidosis is su3stantial for improvingoutcome in geriatric 8C# @ey.ords! intensive care units, ICU mortality, elderly, hyponatemia, serumbicarbonate.  Admission predictors of mortality in Geriatrics intensive care Introduction: /he elderly population is gro.ing in Egypt, li-e in many other countries, /here .ere+,+'',''' persons aged ' and over representing (> of the total population in &''/he eBpected percentage of older people may reach (> in &'1 and 1'(> in&'&01Life eBpectancy for Egyptian females .as )* years in 1( increased to ) yearsin &'' 9hile, Life eBpectancy in males .as '* years in 1( and increased to(& years in &'' 01/his rapid rise in the elderly population .orld.ide is paralleled 3y increase inutiliation of health care resources 0& Moreover, elderly .ill need 8C# admissionmore fre7uently and their management .ill 3e more challengingData sho.ed that **> of all 8C# 3eddays are occupied 3y patients aged  * years 0)Hld age is associated .ith increased mortality in critically ill patients 0+ :o.ever,age alone .asn5t a strong predictor for mortality /here is evidence suggesting thatacute physiological impairment and associated comor3idities .ere predictors of mortality after ad4ustment of age 0*,  the current study .as designed to study predictors for mortality in critically ill elderly patients at the time of admission, the early recognition of patients at high ris- of mortality is needed to plan care in advance and to control healthcare costs  Material and methods:  Study design:
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