Health problems and health care outcomes of older patients admitted to intensive care units in the lowand middle-income countries: A systematic review and meta-analysis
Keywords:
Older patients, Health problems and outcomes, Intensive care unit, Low - and middleincome countriesAbstract
Introduction Older patients admitted to intensive care units (ICUs) hada high mortality rate,
particularly in the low- and middle-income countries (LMICs).
Objectives This systematic review and meta-analysis aims to summarize current prevalence of
health problems and health care outcomes of older patients admitted to ICUs in the LMICs.
Methods We searched seven databases to identify original studies investigating profiles of ICU
admissions of patients aged 60 or overand health care outcomes in the LMICs.All types of
observational studies published from 2010 to 2019 were eligible. Quality assessment of articles
used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and the
Joanna Briggs Institute Checklists (JBI).
Results Tenout of 1,486 observational studies from all sources enrolling a total of 4,915
critically ill older patients from six general- and thirteen specialty ICUs in seven LMICs were
included. The overall quality of the studies was moderate. ICU- and in-hospital mortality pooled
rates of the older patients were 15.6% (95% CI = 14.1-17.2, p = 0.04, I2
= 96.9%) and 33.3%
(95% CI = 22.5-43.9, p<0.001, I2
= 46.6%). Their pooled means (S.D.) of ICU and in-hospital length
of stay were 6.7 (10.6) and 18.8 (8.6) days. Over one-fourth of them had severe conditions and
loss of functional independence on ICU admission. Infection-related problems were evidenced
during ICU stays.
Conclusion Critically ill older patients in the LMICs largely have severe conditions on ICU
admission with over one-tenth of ICU mortality. Patients with acute kidney injury, delirium,
malnutrition, comorbid illnesses, and/or sepsis significantly have increased risk of death and
adverse outcomes.
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