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. 2022 Aug;37(3):372-381.
doi: 10.4266/acc.2022.00066. Epub 2022 Aug 4.

Characteristics and prognostic factors of very elderly patients admitted to the intensive care unit

Song-I Lee  1 , Younsuck Koh  2 , Jin Won Huh  2 , Sang-Bum Hong  2 , Chae-Man Lim  2
Affiliations

Characteristics and prognostic factors of very elderly patients admitted to the intensive care unit

Song-I Lee et al. Acute Crit Care. 2022 Aug.

Abstract

Background: Korea is rapidly becoming a super aging society and is facing the increased burden of critical care for the elderly people. Traditionally, far-advanced age has been regarded as a triage criterion for intensive care unit (ICU) admission. We evaluated how the characteristics and prognostic factors of very elderly patients (≥85 years) admitted to the ICU changed over the last decade.

Methods: We retrospectively evaluated the data of patients admitted to the ICU over 11 years (2007-2017). The clinical characteristics and outcomes of the very elderly-patients group were evaluated. Factors associated with mortality were assessed by a cox regression analysis.

Results: Comparing the first half (2007-2012) and the second half (2013-2017) of the study period, the proportion of very elderly group increased from 603/47,657 (1.3%), to 697/37,756 (1.8%) (P<0.001). Among 1,294 very elderly patients, 1,274 patients were analyzed excluding hopeless discharge (n=20). The non-surgical reasons for ICU admission (67.0% vs. 76.1%, P<0.001) and the percentage of patients with co-morbidities (78.3% vs. 82.7%, P=0.048) were increased. Nevertheless, the hospital mortality decreased (21.3% vs. 14.9%, P=0.001). High creatinine levels, use of vasopressors and ventilator weaning failure were associated with in-hospital mortality.

Conclusions: The proportion of very elderly people in the ICU increased over the last decade. The non-surgical causes of ICU admission increased compared with the surgical causes. Despite an increasement in ICU admissions of very elderly patients, in-hospital mortality of very elderly ICU patients decreased.

Keywords: aging society; critical care; mortality; very elderly.

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Conflict of interest statement

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Flowcharts of patients. ICU: intensive care unit.
Figure 2.
Figure 2.
Number of all patients in the intensive care unit (ICU) and very elderly (aged ≥85 years) patients by year including do-not-resuscitate (DNR) and hopeless discharge.
Figure 3.
Figure 3.
Number of survived and non-survived very elderly patients in the intensive care unit (ICU) and mortality by year.
See this image and copyright information in PMC

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