Clinical trial NCT00912600: Intensive Care Unit (ICU) Admission Decisions in the Elderly : the ICE-CUB Study
Official title: A Prospective Multicenter Study Examining the Criteria That Determine ICU Admission of Patients Over 80 Who Present to an Emergency Department and Evaluating the Impact of ICU Admission on Short and Mid-term Vital and Functional Outcome
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Patient Admission
Death
Activities of Daily Living
Keywords: Intensive Care Units
Triage
Aged, 80 and over
Death
Activities of Daily Living
Health Services Research
Health Care Quality, Access, and Evaluation
Lead sponsor: Assistance Publique - Hôpitaux de Paris
Sponsor class: OTHER
Collaborators: name: Institut National de la Santé Et de la Recherche Médicale, France
First posted: 2009-06-03
Enrollment: 2643
Sex: ALL
Minimum age (years): 80
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Old patients arriving to the emergency department of 15 French hospitals with conditions that potentially warrant ICU admission.

Brief summary: Percentage of patients over 80 admitted in ICU varies greatly from one center to another. ICU admission criteria of older patients are scarcely described and benefit of ICU admission for those patients is uncertain. In this study, we prospectively studied old patients arriving to the emergency department of 15 French hospitals with conditions that potentially warrant ICU admission.The working hypothesis was that ICU admission was associated with a 20% decrease in six-month mortality.

Detailed description: This was a prospective multicenter observational cohort study of elderly individuals presenting to one of 15 emergency departments and possibly qualifying for admission to an ICU. To be included, subjects had to be aged at least 80 years and be diagnosed by the ED physician with one of 74 conditions potentially warranting ICU admission.Outcome studied are ICU eligibility as assessed by emergency and ICU physicians, hospital and six-month death and changes in functional status in the six month following emergency department visit.

Eligibility criteria: Inclusion Criteria:

* Age over 80
* Be assigned by the emergency physician with one of 74 conditions potentially warranting ICU admission

Exclusion Criteria:

* Patient's refusal

Primary outcomes:
measure: ICU eligibility as assessed by emergency and ICU physicians
timeFrame: At the admission
Secondary outcomes:
measure: Hospital death
timeFrame: During the hospitalisation
measure: Change in functional status
timeFrame: During 6 months
measure: Six-month death
timeFrame: During 6 months after the end of the hospitalisation
Other outcomes:
Locations:
city: Paris
country: France
facility: Hôpital Saint-Antoine
Study officials:
affiliation: Assistance Publique - Hôpitaux de Paris
name: Bertrand GUIDET, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Boumendil A, Angus DC, Guitonneau AL, Menn AM, Ginsburg C, Takun K, Davido A, Masmoudi R, Doumenc B, Pateron D, Garrouste-Orgeas M, Somme D, Simon T, Aegerter P, Guidet B; ICE-CUB study group. Variability of intensive care admission decisions for the very elderly. PLoS One. 2012;7(4):e34387. doi: 10.1371/journal.pone.0034387. Epub 2012 Apr 11.