Dataset Information

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

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.

SUBMITTER: Lee SI

PROVIDER: S-EPMC9475142 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

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

Lee Song-I SI Koh Younsuck Y Huh Jin Won JW Hong Sang-Bum SB Lim Chae-Man CM

Acute and critical care 20220804 3

<h4>Background</h4>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.<h4>Methods</h4>We retrospectively evaluated the data of patients admitted to the ICU over 11 year ...[more]

PMID: 35977895

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Project description:ObjectivesTo characterize and compare trends in ICU admission, hospital outcomes, and resource utilization for critically ill very elderly patients (≥ 80 yr old) compared with the younger cohort (16-79 yr old).DesignA retrospective multicenter cohort study.SettingOne-hundred ninety-four ICUs contributing data to the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database between January 2006 and December 2018.PatientsAdult (≥ 16 yr) patients admitted to Australian and New Zealand ICUs.InterventionsNone.Measurements and main resultsVery elderly patients with a mean ± sd age of 84.8 ± 3.7 years accounted for 14.8% (232,582/1,568,959) of all adult ICU admissions. They had higher comorbid disease burden and illness severity scores compared with the younger cohort. Hospital (15.4% vs 7.8%, p < 0.001) and ICU mortality (8.5% vs 5.2%, p < 0.001) were higher in the very elderly. They stayed fewer days in ICU, but longer in hospital and had more ICU readmissions. Among survivors, a lower proportion of very elderly was discharged home (65.2% vs 82.4%, p < 0.001), and a higher proportion was discharged to chronic care/nursing home facilities (20.1% vs 7.8%, p < 0.001). Although there was no change in the proportion of very elderly ICU admissions over the study period, they showed a greater decline in risk-adjusted mortality (6.3% [95% CI, 5.9%-6.7%] vs 4.0% [95% CI, 3.7%-4.2%] relative reduction per year, p < 0.001) compared with the younger cohort. The mortality of very elderly unplanned ICU admissions improved faster than the younger cohort ( p < 0.001), whereas improvements in mortality among elective surgical ICU admissions were similar in both groups ( p = 0.45).ConclusionsThe proportion of ICU admissions greater than or equal to 80 years old did not change over the 13-year study period. Although their mortality was higher, they showed improved survivorship over time, especially in the unplanned ICU admission subgroup. A higher proportion of survivors were discharged to chronic care facilities.

Dataset Information

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

Background

Methods

Results

Conclusions

Publications

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

Similar Datasets

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