Acute respiratory failure in the elderly: etiology, emergency diagnosis and prognosis

2006

Causes and Diagnosis of Acute Respiratory Failure in Elderly Patients

Sample size: 514 publication 10 minutes Evidence: high

Author Information

Author(s): Ray Patrick, Birolleau Sophie, Lefort Yannick, Becquemin Marie-Hélène, Beigelman Catherine, Isnard Richard, Teixeira Antonio, Arthaud Martine, Riou Bruno, Boddaert Jacques

Primary Institution: Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris

Hypothesis

What are the causes of acute respiratory failure in elderly patients and how accurate is the initial diagnosis by emergency physicians?

Conclusion

Inappropriate initial treatment in the emergency room was associated with increased mortality in elderly patients with acute respiratory failure.

Supporting Evidence

The main causes of acute respiratory failure were cardiogenic pulmonary edema (43%) and community-acquired pneumonia (35%).
In-hospital mortality was 16%.
A missed diagnosis in the emergency department was noted in 20% of patients.
Inappropriate treatment occurred in 32% of patients, leading to higher mortality.
Predictive variables of death included inappropriate initial treatment and hypercapnia.

Takeaway

This study looked at older people who had trouble breathing and found that if they didn't get the right treatment right away, they were more likely to get very sick or die.

Methodology

This was a prospective observational study of elderly patients admitted to the emergency department with acute dyspnea and criteria for acute respiratory failure.