Left Anterior Fascicular Block and the Risk of Cardiovascular Outcomes

panding from 6.4% of patients receiving IMV in 2001 to 13.8% in 2011 at an annual growth rate of 11.4% per year (Figure).By 2020, we estimate that there will be 671 986 (SD, 19 922) hospitalizations of patients 65 years or older requiring IMV, of which 19.0% will have a diagnosis of dementia.Discussion | The use of IMV by populations 65 years or older is expected to double between 2001 and 2020, and growth in hospitalizations for patients receiving IMV with an ICD-9-CM diagnosis of dementia is outpacing, by a factor of 4, those for patients receiving IMV without this diagnosis.These projected IMV numbers are consistent with published data. 5,6he use of ICD-9-CM codes to identify patients with dementia may be limited by poor sensitivity and lack of information about disease severity.Although better recognition of dementia among hospital providers may have contributed to some of the increase that we observed, the results of this study still have important implications for critical care resource planning.Given projected demand for IMV in the next 10 years, physicians and hospital administrators, already working in a strained system, face a potential crisis unless the critical care system is expanded or changes are made to temper current trends.Efforts should therefore be made to promote earlier discussions about goals of care in elderly patients with endstage terminal illnesses.This is most important for the subpopulations of patients (eg, frail elders older than 85 years, patients with end-stage dementia)