Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Oct;38(10):1654-61.
doi: 10.1007/s00134-012-2629-6. Epub 2012 Jul 14.

ICU admission characteristics and mortality rates among elderly and very elderly patients

Lior Fuchs  1 , Catherine E Chronaki, Shinhyuk Park, Victor Novack, Yael Baumfeld, Daniel Scott, Stuart McLennan, Daniel Talmor, Leo Celi
Affiliations

ICU admission characteristics and mortality rates among elderly and very elderly patients

Lior Fuchs et al. Intensive Care Med. 2012 Oct.

Abstract

Purpose: The effect of advanced age per se versus severity of chronic and acute diseases on the short- and long-term survival of older patients admitted to the intensive care unit (ICU) remains unclear.

Methods: Intensive care unit admissions to the surgical ICU and medical ICU of patients older than 65 years were analyzed. Patients were divided into three age groups: 65-74, 75-84, and 85 and above. The primary endpoints were 28-day and 1-year mortality.

Results: The analysis focused on 7,265 patients above the age of 65, representing 45.7 % of the total ICU population. From the first to third age group there was increased prevalence of heart failure (25.9-40.3 %), cardiac arrhythmia (24.6-43.5 %), and valvular heart disease (7.5-15.8 %). There was reduced prevalence of diabetes complications (7.5-2.4 %), alcohol abuse (4.1-0.6 %), chronic obstructive pulmonary disease (COPD) (24.4-17.4 %), and liver failure (5.0-1.0 %). Logistic regression analysis adjusted for gender, sequential organ failure assessment, do not resuscitate, and Elixhauser score found that patients from the second and third age group had odds ratios of 1.38 [95 % confidence interval (CI) 1.19-1.59] and 1.53 (95 % CI 1.29-1.81) for 28-day mortality as compared with the first age group. Cox regression analysis for 1-year mortality in all populations and in 28-day survivors showed the same trend.

Conclusions: The proportion of elderly patients from the total ICU population is high. With advancing age, the proportion of various preexisting comorbidities and the primary reason for ICU admission change. Advanced age should be regarded as a significant independent risk factor for mortality, especially for ICU patients older than 75.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Patient population flowchart
Fig. 2
Fig. 2
a LOESS adjusted 28-day mortality probability by age. Risks are adjusted for gender, SOFA at admission, Elixhauser, and DNR status. b LOESS adjusted 1-year mortality probability by age in 28-day survivors. Risks are adjusted for gender, SOFA at admission, Elixhauser, and DNR status
See this image and copyright information in PMC

References

    1. Oeppen J, Vaupel JW. Demography. Broken limits to life expectancy. Science. 2002;296:1029–1031. - PubMed
    1. Fowler RA, Adhikari NK, Bhagwanjee S. Clinical review: critical care in the global context—disparities in burden of illness, access, and economics. Crit Care. 2008;12:225. - PMC - PubMed
    1. Nguyen YL, Angus DC, Boumendil A, Guidet B. The challenge of admitting the very elderly to intensive care. Ann Intensive Care. 2011;1:29. - PMC - PubMed
    1. Bagshaw SM, Webb SA, Delaney A, George C, Pilcher D, Hart GK, Bellomo R. Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis. Crit Care. 2009;13:R45. - PMC - PubMed
    1. de Rooij SE, Govers A, Korevaar JC, Abu-Hanna A, Levi M, de Jonge E. Short-term and long-term mortality in very elderly patients admitted to an intensive care unit. Intensive Care Med. 2006;32:1039–1044. - PubMed