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A1118 - Trends in Intensive Care Admissions for Respiratory Infections in the Elderly in French Hospitals 2006-2015
Author Block: A. Guillon1, L. Laporte1, C. Hermetet2, Y. Jouan1, C. Gaborit2, M. Si-Tahar3, P. Dequin1, L. Grammatico-Guillon2; 1CHU Tours, Medecine Intensive Reanimation, Tours, France, 2CHU Tours, Service d’Information Médicale, d'Epidémiologie et d'Economie de la Santé, Tours, France, 3INSERM, Centre d'Etude des Pathologies Respiratoires, U1100, France, Tours, France.
Rationale. Current forecasts predict that by 2050, the percentage of the population older than 80 years will double. The percentage of ICU admissions attributable to the elderly now varied from approximately 10 to 20% and longitudinal studies further showed that this rate increased yearly. Most studies considering ICU admissions of the elderly have focused on the elderly as a single entity. We strongly believe that the discussion should be disease-specific. To our point of view, a focus on respiratory infections is of particular interest because it is strongly associated with old age. We hypothesized that the increase in the percentage of ageing patients in the population is likely to automatically increase the hospital stays for respiratory infections and the ICU admissions. The objective of our study was to describe trends in demographics over a decade among elderly patients admitted in ICU for acute respiratory infection. Methods. We conducted a retrospective study based on hospital discharge databases in a French region (2.5 million inhabitants, 39 hospitals) between 2006 and 2015. The study population comprised all patients aged 18 years or older who were hospitalized in the region. Cases of acute respiratory infection were extracted from the databases using an algorithm based on ICD-10-specific codes. Correlations between changing in respiratory infection hospitalizations and years were evaluated using Pearson correlation tests. Results. A total of 98,381 hospital stays for acute respiratory infection were identified among the 3,856,785 stays of the healthcare facilities during the 10-year period. The number of patients up to 75 y/o increased by 1.6-fold from 2006 to 2015, whereas those of the 85-89 and >or=90 y/o or more increased by 2.5 and 2.1-fold, respectively. ICU-hospitalizations for respiratory infection increased 2.7-fold (p = 0.0002). Rate of ICU-admission increased from 11.0% (2006) to 17.1% (2015) (p = 0.002). The greatest increases in ICU admissions were for the 85-89 and >or=90 y/o: 3.3 and 5.8-fold respectively. Indeed, the proportion of the elderly hospitalized for respiratory infection in ICU clearly amplified during the decade: 11.3% were aged >or=85 y/o in 2006 vs 16.4% in 2015 (p=0.0002). The increase of ageing patients was not associated with a significant change in ICU mortality, except for the >or=90 y/o (40.9 to 22.3%, p=0.03). Conclusion. Both the absolute number and the percentage of ICU admissions of the elderly increased over the last decade, driving an overall 2.7-fold increase in the number of ICU stays for acute respiratory infection.