What is it about?
We conducted a secondary analysis of three prospective multicentre registries, VIP1, VIP2, and COVIP, including acutely admitted older ICU patients with available Clinical Frailty Scale assessment,country-level Human Development Index (HDI), and 30-day vital status. Among 9920 patients included in the primary analysis, 8324 (83.9%) were treated in countries withHDI ≥ 0.90 and 1596 (16.1%) in countries with HDI < 0.90. Thirty-day mortality was lower in high-HDI countries than in lower-HDI countries (40.0% vs. 53.3%).
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Why is it important?
In this large European cohort of older critically ill patients, treatment in countries withexceptionally high human development was associated with lower 30-day mortality. The association persisted after adjustment for patient-level severity, frailty, treatment limitation, organ support, study cohort, and ICUbed capacity. These findings suggest that country-level development and ICU management patterns, particularly invasive ventilation practices, may contribute to outcome differences. Because this was anobservational secondary analysis using country-level exposure data, causal interpretation should remaincautious.
Perspectives
This study adds to the knowlegde of what is impotant in order to understand ICU outcomes of very old patients in different European countries.
Prof <hans Flaatten
Universitetet i Bergen
Read the Original
This page is a summary of: Human Development Index and outcomes in older critically ill patients: A European multicentre study, Annals of Intensive Care, January 2026, Elsevier,
DOI: 10.1016/j.aicoj.2026.100101.
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