{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:50:34Z","timestamp":1792183834088,"version":"4.4.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2006,5,24]],"date-time":"2006-05-24T00:00:00Z","timestamp":1148428800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2006,5,24]],"date-time":"2006-05-24T00:00:00Z","timestamp":1148428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Our objectives were to determine the causes of acute respiratory failure (ARF) in elderly patients and to assess the accuracy of the initial diagnosis by the emergency physician, and that of the prognosis.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Method<\/jats:title>\n                        <jats:p>In this prospective observational study, patients were included if they were admitted to our emergency department, aged 65 years or more with dyspnea, and fulfilled at least one of the following criteria of ARF: respiratory rate at least 25 minute<jats:sup>-1<\/jats:sup>; arterial partial pressure of oxygen (PaO<jats:sub>2<\/jats:sub>) 70 mmHg or less, or peripheral oxygen saturation 92% or less in breathing room air; arterial partial pressure of CO<jats:sub>2<\/jats:sub> (PaCO<jats:sub>2<\/jats:sub>) \u2265 45 mmHg, with pH \u2264 7.35. The final diagnoses were determined by an expert panel from the completed medical chart.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>A total of 514 patients (aged (mean \u00b1 standard deviation) 80 \u00b1 9 years) were included. The main causes of ARF were cardiogenic pulmonary edema (43%), community-acquired pneumonia (35%), acute exacerbation of chronic respiratory disease (32%), pulmonary embolism (18%), and acute asthma (3%); 47% had more than two diagnoses. In-hospital mortality was 16%. A missed diagnosis in the emergency department was noted in 101 (20%) patients. The accuracy of the diagnosis of the emergency physician ranged from 0.76 for cardiogenic pulmonary edema to 0.96 for asthma. An inappropriate treatment occurred in 162 (32%) patients, and lead to a higher mortality (25% versus 11%; <jats:italic>p<\/jats:italic> &lt; 0.001). In a multivariate analysis, inappropriate initial treatment (odds ratio 2.83, <jats:italic>p<\/jats:italic> &lt; 0.002), hypercapnia &gt; 45 mmHg (odds ratio 2.79, <jats:italic>p<\/jats:italic> &lt; 0.004), clearance of creatinine &lt; 50 ml minute<jats:sup>-1<\/jats:sup> (odds ratio 2.37, <jats:italic>p<\/jats:italic> &lt; 0.013), elevated NT-pro-B-type natriuretic peptide or B-type natriuretic peptide (odds ratio 2.06, <jats:italic>p<\/jats:italic> &lt; 0.046), and clinical signs of acute ventilatory failure (odds ratio 1.98, <jats:italic>p<\/jats:italic> &lt; 0.047) were predictive of death.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>Inappropriate initial treatment in the emergency room was associated with increased mortality in elderly patients with ARF.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc4926","type":"journal-article","created":{"date-parts":[[2006,5,24]],"date-time":"2006-05-24T18:27:16Z","timestamp":1148495236000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":323,"title":["Acute respiratory failure in the elderly: etiology, emergency diagnosis and prognosis"],"prefix":"10.1186","volume":"10","author":[{"given":"Patrick","family":"Ray","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Birolleau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannick","family":"Lefort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-H\u00e9l\u00e8ne","family":"Becquemin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Beigelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Isnard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Teixeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Arthaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Riou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Boddaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2006,5,24]]},"reference":[{"key":"4449_CR1","doi-asserted-by":"publisher","first-page":"M88","DOI":"10.1093\/gerona\/56.2.M88","volume":"56","author":"MW Rich","year":"2001","unstructured":"Rich MW: Heart failure in the 21st century: a cardiogeriatric syndrome.\n                           J Gerontol A Biol Sci Med Sci 2001, 56: M88-M96.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"4449_CR2","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1007\/s00134-003-2150-z","volume":"30","author":"A Boumendil","year":"2004","unstructured":"Boumendil A, Maury E, Reinhard I, Luquel L, Offenstadt G, Guidet B: Prognosis of patients aged 80 years and over admitted in medical intensive care unit.\n                           Intensive Care Med 2004, 30: 647-654. 10.1007\/s00134-003-2150-z","journal-title":"Intensive Care Med"},{"key":"4449_CR3","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1016\/S0196-0644(99)70161-7","volume":"34","author":"MH Chin","year":"1999","unstructured":"Chin MH, Jin L, Karrison TG, Mulliken R, Hayley DC, Walter J, Miller A, Friedmann PD: Older patients' health-related quality of life around an episode of emergency illness.\n                           Ann Emerg Med 1999, 34: 595-603. 10.1016\/S0196-0644(99)70161-7","journal-title":"Ann Emerg Med"},{"key":"4449_CR4","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1016\/S0195-668X(02)00700-5","volume":"24","author":"M Komajda","year":"2003","unstructured":"Komajda M, Follath F, Swedberg K, Cleland J, Aguilar JC, Cohen-Solal A, Dietz R, Gavazzi A, Van Gilst WH, Hobbs R, et al.: The EuroHeart Failure Survey programme \u2013 a survey on the quality of care among patients with heart failure in Europe. 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