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  1. Article: The critically ill older patient with sepsis: a narrative review.

    Ibarz, Mercedes / Haas, Lenneke E M / Ceccato, Adrián / Artigas, Antonio

    Annals of intensive care

    2024  Volume 14, Issue 1, Page(s) 6

    Abstract: Sepsis is a significant public health concern, particularly affecting individuals above 70 years in developed countries. This is a crucial fact due to the increasing aging population, their heightened vulnerability to sepsis, and the associated high ... ...

    Abstract Sepsis is a significant public health concern, particularly affecting individuals above 70 years in developed countries. This is a crucial fact due to the increasing aging population, their heightened vulnerability to sepsis, and the associated high mortality rates. However, the morbidity and long-term outcomes are even more notable. While many patients respond well to timely and appropriate interventions, it is imperative to enhance efforts in identifying, documenting, preventing, and treating sepsis. Managing sepsis in older patients poses greater challenges and necessitates a comprehensive understanding of predisposing factors and a heightened suspicion for diagnosing infections and assessing the risk of sudden deterioration into sepsis. Despite age often being considered an independent risk factor for mortality and morbidity, recent research emphasizes the pivotal roles of frailty, disease severity, and comorbid conditions in influencing health outcomes. In addition, it is important to inquire about the patient's preferences and establish a personalized treatment plan that considers their potential for recovery with quality of life and functional outcomes. This review provides a summary of the most crucial aspects to consider when dealing with an old critically ill patient with sepsis.
    Language English
    Publishing date 2024-01-10
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-023-01233-7
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  2. Article ; Online: Welke tachtigplussers profiteren van intensive care?

    van Dijk, Diederik / van Lelyveld-Haas, Lenneke E M / Fikkers, Bernard G

    Nederlands tijdschrift voor geneeskunde

    2024  Volume 168

    Abstract: Intensive care unit (ICU) treatment can be associated with substantial suffering of patients, and those over eighty years old carry a much worse prognosis than younger ICU patients. Nevertheless, in the Netherlands we admit many people over the age of ... ...

    Title translation Which octogenarians benefit from the intensive care unit? A proposal for triage.
    Abstract Intensive care unit (ICU) treatment can be associated with substantial suffering of patients, and those over eighty years old carry a much worse prognosis than younger ICU patients. Nevertheless, in the Netherlands we admit many people over the age of eighty to the ICU. Is this good practice? Whilst some elderly people may benefit, others don't. ICU treatment without mechanical ventilation is associated with less suffering, can still lead to a good outcome, and thus can often be justified in patients over eighty years. Full ICU treatment including prolonged mechanical ventilation, however, should only be used in selected cases.
    MeSH term(s) Aged ; Aged, 80 and over ; Humans ; Octogenarians ; Triage ; Intensive Care Units ; Critical Care ; Hospitalization
    Language Dutch
    Publishing date 2024-03-05
    Publishing country Netherlands
    Document type English Abstract ; Journal Article
    ZDB-ID 82073-8
    ISSN 1876-8784 ; 0028-2162
    ISSN (online) 1876-8784
    ISSN 0028-2162
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    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.18: Show issues Location:
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  3. Article ; Online: Increased mortality in ICU patients ≥70 years old with COVID-19 compared to patients with other pneumonias.

    Haas, Lenneke E M / Termorshuizen, Fabian / den Uil, Corstiaan A / de Keizer, Nicolette F / de Lange, Dylan W

    Journal of the American Geriatrics Society

    2023  Volume 71, Issue 5, Page(s) 1440–1451

    Abstract: ... in a historical (i.e., January 1st 2017 to January 1st 2020) and current cohort (i.e., March 1st 2020 to January ...

    Abstract Background: Patients over 70 years old represent a substantial proportion of the COVID-19 ICU population and their mortality rates are high. The aim of this study is to describe the outcomes of patients ≥70 years old admitted to Dutch ICUs with COVID-19, compared to patients ≥70 years old admitted to the ICU for bacterial and other viral pneumonias, with adjustments for age, comorbidities, severity of illness, and ICU occupancy rate.
    Methods: Retrospective cohort study including patients ≥70 years old admitted to Dutch ICUs, comparing patients admitted with COVID-19 from March 1st 2020 to January 1st 2022 with patients ≥70 years old admitted because of a bacterial and other viral pneumonia, both divided in a historical (i.e., January 1st 2017 to January 1st 2020) and current cohort (i.e., March 1st 2020 to January 1st 2022). Primary outcome is hospital mortality.
    Results: 11,525 unique patients ≥70 years old admitted to Dutch ICUs were included; 5094 with COVID-19, 5334 with a bacterial pneumonia, and 1312 with another viral pneumonia. ICU-mortality and in-hospital mortality rates of the patients ≥70 years old admitted with COVID-19 were 39.7% and 47.6% respectively. ICU- and hospital mortality rates of the patients who were admitted in the same or in an historical time period with a bacterial pneumonia or other viral pneumonias were considerably lower (19.5% and 28.6% for patients with a bacterial pneumonia in the historical cohort and 19.1% and 28.8% in the same period, for the patients with other viral pneumonias 20.7% and 28.9%, and 22.7% and 31.8% respectively, all p < 0.001). Differences persisted after correction for several clinical characteristics and ICU occupancy rate.
    Conclusions: In ICU-patients ≥70 years old, COVID-19 is more severe compared to bacterial or viral pneumonia.
    MeSH term(s) Humans ; Male ; Female ; Aged ; Aged, 80 and over ; Retrospective Studies ; COVID-19/mortality ; Netherlands/epidemiology ; Intensive Care Units ; Hospital Mortality ; Treatment Outcome ; Pneumonia, Viral ; Pneumonia, Bacterial
    Language English
    Publishing date 2023-02-08
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80363-7
    ISSN 1532-5415 ; 0002-8614
    ISSN (online) 1532-5415
    ISSN 0002-8614
    DOI 10.1111/jgs.18220
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    In stock of ZB MED Cologne/Königswinter

    Ud II Zs.168: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Should we deny ICU admission to the elderly? Ethical considerations in times of COVID-19.

    Haas, Lenneke E M / de Lange, Dylan W / van Dijk, Diederik / van Delden, Johannes J M

    Critical care (London, England)

    2020  Volume 24, Issue 1, Page(s) 321

    MeSH term(s) Aged ; COVID-19 ; Coronavirus Infections/epidemiology ; Critical Care/ethics ; Humans ; Intensive Care Units ; Pandemics ; Patient Admission ; Pneumonia, Viral/epidemiology ; Refusal to Treat/ethics
    Keywords covid19
    Language English
    Publishing date 2020-06-09
    Publishing country England
    Document type Letter
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-020-03050-x
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5517: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  5. Article ; Online: Differential abundance of IgG antibodies against the spike protein of SARS-CoV-2 and seasonal coronaviruses in patients with fatal COVID-19.

    Smit, Wouter L / van Tol, Sophie / Haas, Lenneke E M / Limonard, Gijs J M / Bossink, Ailko / Reusken, Chantal / Heron, Michiel / Thijsen, Steven F T

    Virology journal

    2023  Volume 20, Issue 1, Page(s) 85

    Abstract: Infection with the novel pandemic SARS-CoV-2 virus has been shown to elicit a cross-reactive immune response that could lead to a back-boost of memory recall to previously encountered seasonal (endemic) coronaviruses (eCoVs). Whether this response is ... ...

    Abstract Infection with the novel pandemic SARS-CoV-2 virus has been shown to elicit a cross-reactive immune response that could lead to a back-boost of memory recall to previously encountered seasonal (endemic) coronaviruses (eCoVs). Whether this response is associated with a fatal clinical outcome in patients with severe COVID-19 remains unclear. In a cohort of hospitalized patients, we have previously shown that heterologous immune responses to eCoVs can be detected in severe COVID-19. Here, we report that COVID-19 patients with fatal disease have decreased SARS-CoV-2 neutralizing antibody titers at hospital admission, which correlated with lower SARS-CoV-2 spike-specific IgG and was paralleled by a relative abundance of IgG against spike protein of eCoVs of the genus Betacoronavirus. Additional research is needed to assess if eCoV-specific back-boosted IgG is a bystander phenomenon in severe COVID-19, or a factor that influences the development of an efficient anti-viral immune response.
    MeSH term(s) Humans ; COVID-19 ; SARS-CoV-2 ; Immunoglobulin G ; Spike Glycoprotein, Coronavirus ; Seasons ; Antibodies, Viral ; Antibodies, Neutralizing
    Chemical Substances Immunoglobulin G ; spike protein, SARS-CoV-2 ; Spike Glycoprotein, Coronavirus ; Antibodies, Viral ; Antibodies, Neutralizing
    Language English
    Publishing date 2023-05-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2160640-7
    ISSN 1743-422X ; 1743-422X
    ISSN (online) 1743-422X
    ISSN 1743-422X
    DOI 10.1186/s12985-023-02050-x
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  7. Article ; Online: The Art of Intensive Care Medicine in the Aging Population.

    Haas, Lenneke E M / Karakus, Attila / de Keizer, Nicolette F

    Critical care medicine

    2016  Volume 44, Issue 8, Page(s) e776–7

    MeSH term(s) Aging ; Critical Care ; Humans ; Medicine
    Language English
    Publishing date 2016
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000001798
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1261: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  8. Article ; Online: Should we deny ICU admission to the elderly? Ethical considerations in times of COVID-19

    Lenneke E. M. Haas / Dylan W. de Lange / Diederik van Dijk / Johannes J. M. van Delden

    Critical Care, Vol 24, Iss 1, Pp 1-

    2020  Volume 3

    Keywords ICU ; Critical care ; Ethics ; Triage ; Age ; Elderly ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; covid19
    Language English
    Publishing date 2020-06-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Should we deny ICU admission to the elderly? Ethical considerations in times of COVID-19

    Haas, Lenneke E. M. / de Lange, Dylan W. / van Dijk, Diederik / van Delden, Johannes J. M.

    Critical Care

    2020  Volume 24, Issue 1

    Keywords Critical Care and Intensive Care Medicine ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    ZDB-ID 2041406-7
    ISSN 1364-8535
    ISSN 1364-8535
    DOI 10.1186/s13054-020-03050-x
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5517: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  10. Article: The association of premorbid conditions with 6-month mortality in acutely admitted ICU patients over 80 years.

    de Lange, Dylan W / Soliman, Ivo W / Leaver, Susannah / Boumendil, Ariane / Haas, Lenneke E M / Watson, Ximena / Boulanger, Carol / Szczeklik, Wojciech / Artigas, Antonio / Morandi, Alessandro / Andersen, Finn / Jung, Christian / Moreno, Rui / Walther, Sten / Oeyen, Sandra / Schefold, Joerg C / Cecconi, Maurizio / Marsh, Brian / Joannidis, Michael /
    Nalapko, Yuriy / Elhadi, Muhammed / Fjølner, Jesper / Guidet, Bertrand / Flaatten, Hans

    Annals of intensive care

    2024  Volume 14, Issue 1, Page(s) 46

    Abstract: Background: Premorbid conditions influence the outcome of acutely ill adult patients aged 80 years and over who are admitted to the ICU. The aim of this study was to determine the influence of such premorbid conditions on 6 month survival.: Methods: ... ...

    Abstract Background: Premorbid conditions influence the outcome of acutely ill adult patients aged 80 years and over who are admitted to the ICU. The aim of this study was to determine the influence of such premorbid conditions on 6 month survival.
    Methods: Prospective cohort study in 242 ICUs from 22 countries including patients 80 years or above, admitted over a 6 months period to an ICU between May 2018 and May 2019. Only emergency (acute) ICU admissions in adult patients ≥ 80 years of age were eligible. Patients who were admitted after planned/elective surgery were excluded. We measured the Clinical Frailty Scale (CFS), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), disability with the Katz activities of daily living (ADL) score, comorbidities and a Polypharmacy Score (CPS).
    Results: Overall, the VIP2 study included 3920 patients. During ICU stay 1191 patients died (30.9%), and another 436 patients (11.1%) died after ICU discharge but within the first 30 days of admission, and an additional 895 patients died hereafter but within the first 6 months after admission (22.8%). The 6 months mortality was 64%. The median CFS was 4 (IQR 3-6). Frailty (CFS ≥ 5) was present in 26.6%. Cognitive decline (IQCODE above 3.5) was found in 30.2%. The median IQCODE was 3.19. A Katz ADL of 4 or less was present in 27.7%. Patients who surviving > 6 months were slightly younger (median age survivors 84 with IQR 81-86) than patients dying within the first 6 months (median age 84, IQR 82-87, p = 0.013), were less frequently frail (CFS > 5 in 19% versus 34%, p < 0.01) and were less dependent based on their Katz activities of daily living measurement (median Katz score 6, IQR 5-6 versus 6 points, IQR 3-6, p < 0.01).
    Conclusions: We found that Clinical Frailty Scale, age, and SOFA at admission were independent prognostic factors for 6 month mortality after ICU admission in patients age 80 and above. Adding other geriatric syndromes and scores did not improve the model. This information can be used in shared-decision making.
    Clinicaltrials: gov: NCT03370692.
    Language English
    Publishing date 2024-03-30
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2617094-2
    ISSN 2110-5820
    ISSN 2110-5820
    DOI 10.1186/s13613-024-01246-w
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