ICU sedation, delirium & recovery
Human Development Index and outcomes in older critically ill patients: A European multicentre study
Authors' conclusion
In this large European cohort of older critically ill patients, treatment in countries with exceptionally high human development was associated with lower 30-day mortality.
Study context
- Population
- Acutely admitted older ICU patients (VIP1/VIP2 aged ≥80 years; COVIP aged ≥70 years) with Clinical Frailty Scale assessment, country-level Human Development Index (HDI) and 30-day vital statusprimary analysis
- Participants
- 9,920 participants
- Comparison
- Treatment in countries with HDI ≥ 0.90 vs <0.90
- HDI ≥ 0.90n = 8,324
- HDI < 0.90n = 1,596reference
- Primary endpoint
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsVIP1, VIP2, COVIP, logistic regression with robust SEs clustered by country, exploratory mediation analyses
- VIP1, VIP2, COVIP
- Logistic regression with robust SEs clustered by country
- Exploratory mediation analyses
Primary result
As reported in the abstract
HDI ≥ 0.90 vs HDI < 0.90Estimate (95% CI)P value
Unadjusted
OR 0.58(0.38–0.90)
P = 0.016Multivariable adjustment
aOR 0.49(0.31–0.80)
P = 0.004Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| 30-day mortality, additionally adjusted for study cohort | 0.49 (0.31–0.77) | P = 0.002 | |
| 30-day mortality, additionally adjusted for ICU bed capacity | 0.50 (0.29–0.86) | P = 0.013 | |
| 0.20.5125Adjusted odds ratio (log scale) |
30-day mortality, HDI modelled continuously (full adjustment)
- OR per 0.10-unit HDI increase
- 0.33 (95% CI 0.19-0.56; P < 0.001)
Mediation by invasive mechanical ventilation (exploratory)
- NIE OR, lower use of invasive mechanical ventilation in high-HDI countries may partially contribute
- 0.86 (95% CI 0.83-0.89)
- Exploratory mediation analyses
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Human Development Index and outcomes in older critically ill patients: A European multicentre study. Ann Intensive Care. Published 19 June 2026. doi:10.
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