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Record W2110117118 · doi:10.1097/ccm.0000000000001024

The Very Elderly Admitted to ICU

2015· article· en· W2110117118 on OpenAlexafffundabout
Daren K. Heyland, Sean M. Bagshaw, Allan Garland, Henry T. Stelfox, Sangeeta Mehta, Peter Dodek, Karen E. A. Burns, John Muscedere, Alexis F. Turgeon, Rob Fowler, Xuran Jiang, Andrew G. Day

Bibliographic record

VenueCritical Care Medicine · 2015
Typearticle
Languageen
FieldMedicine
TopicPalliative Care and End-of-Life Issues
Canadian institutionsSunnybrook HospitalQueen's UniversitySt. Michael's HospitalUniversity of British ColumbiaKingston General HospitalMount Sinai HospitalUniversity of CalgarySt. Paul's HospitalAlberta Health ServicesThe Quebec Population Health Research NetworkMcMaster UniversityClinical Evaluation Research UnitUniversity of ManitobaUniversity of TorontoUniversity of Alberta
FundersCanadian Institutes of Health Research
KeywordsMedicineInterquartile rangeMechanical ventilationIntensive care unitProspective cohort studyEmergency medicineIntensive careRenal replacement therapyCohortCohort studyDialysisSAPS IIIntensive care medicineAPACHE IIInternal medicine

Abstract

fetched live from OpenAlex

OBJECTIVE: Very elderly persons admitted to ICUs are at high risk of death. To document life-sustaining interventions (mechanical ventilation, vasopressors, renal replacement therapy) provided in the ICU and outcomes of care. DESIGN: Multicenter, prospective cohort study. SETTING: ICUs of 24 Canadian hospitals. PARTICIPANTS/SETTING: Patients 80 years old or older admitted to the ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: One thousand six hundred seventy-one patients were included. The average age of the cohort was 85 years (range, 80-100 yr). Median total length of stay in ICU was 4 days (interquartile range, 2-8 d) and in hospital was 17 days (interquartile range, 8-33 d). Of all patients included, 502 (30%) stayed in ICU for 7 days or more and 344 (21%) received some form of life-sustaining treatment for at least 7 days. ICU and hospital mortality were 22% and 35%, respectively. For nonsurvivors, the median time from ICU admission to death was 10 days (interquartile range, 3-20 d). Of those who died (n = 5 85), 289 (49%) died while receiving mechanical ventilation, vasopressors, or dialysis. The presence of frailty or advance directives had little impact on limiting use of life-sustaining treatments or shortening the time from admission to death. CONCLUSIONS: In this multicenter study, one third of very elderly ICU patients died in hospital, many after a prolonged ICU stay while continuing to receive aggressive life-sustaining interventions. These findings raise questions about the use of critical care at the end of life for the very elderly.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.012
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.349
Threshold uncertainty score0.997

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.012
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.170
GPT teacher head0.466
Teacher spread0.296 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations199
Published2015
Admission routes3
Has abstractyes

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