Intensive care requirements for an ageing population--a microcosm of problems facing the NHS?

Abstract

The changing patterns of admissions to an intensive care unit (ICU) were investigated in relation to age. The local population and the patients admitted to ICU in each year from 1996 to 2002 were stratified by age. The trend in the ratio of admissions to population showed the most extreme changes in those aged > or = 60 years. For this group, there was an increase of 2.62 admissions per 10,000 population per year (95% Confidence interval (CI) 1.41 to 3.85, p = 0.004). APACHE II (Acute Physiology and Chronic Health Evaluation II) scores increased by 0.45 points per year (95% CI 0.16 to 0.74, p = 0.013) and length of ICU stay increased by 0.21 days per year (95% CI 0.03 to 0.38, p = 0.032). This rapid increase in the use of ICU resources by patients aged > or = 60 years over a period of six years, combined with an ageing population, suggests that current projections of future ICU provision may be inadequate.