Critically ill old and the oldest-old patients in intensive care: short- and long-term outcomes.
OBJECTIVE
The purpose of this study was to examine characteristics and outcome of the old, very old and oldest-old ICU patients DESIGN. This is a cohort study.


METHODS
The study was set in a ten-bed medical ICU in a university hospital. PARTICIPANTS. There were 410 patients classified in three subgroups: old, 75-79 years ( n=184; 44.4%), very old, 80-84 ( n=137, 33.4%) and the oldest-old, >or=85 ( n=91; 22.2%).


METHODS
Underlying medical conditions, organ dysfunction, severity of illness, length of stay, use of mechanical ventilation, therapeutic activity and nosocomial infections were recorded. Multivariate analysis was conducted to identify risk factors for ICU and long-term mortality.


RESULTS
Characteristics at ICU admission did not differ among the three groups. ICU length of stay, therapeutic activity, mechanical ventilation and nosocomial infection(s) decreased with age. ICU survival rates for those below 75, 75-79, 80-84 and over 85 years were 80, 68, 75 and 69%, respectively; survival rates at 3 months were 54, 56 and 51%, respectively. APACHE II score [odds ratio (OR): 1.11] was identified as the only factor associated with ICU mortality, and age (OR: 2.17, for patients >or=85 years old and 1.82, for patients 80-84 years old) and limitation of activity before admission (OR: 1.74) as factors associated with long-term mortality.


CONCLUSIONS
In a population of patients >or=75 years old, very old age is not directly associated with ICU mortality. After ICU discharge, deaths occurred predominantly during the first 3 months: age and prior limitation of activity were associated with the risk of dying.
Somme
Dominique
D
Service de Gériatrie, Hôpital Européen Georges-Pompidou, 75908 , Paris Cedex 15, France.
Maillet
Jean-Michel
JM
Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75908 , Paris Cedex 15, France.
Gisselbrecht
Mathilde
M
Service de Gériatrie, Hôpital Européen Georges-Pompidou, 75908 , Paris Cedex 15, France.
Novara
Ana
A
Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75908 , Paris Cedex 15, France.
Ract
Catherine
C
Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75908 , Paris Cedex 15, France.
Fagon
Jean-Yves
JY
Service de Réanimation Médicale, Hôpital Européen Georges-Pompidou, 20 rue Leblanc, 75908 , Paris Cedex 15, France. jean-yves.fagon@hop.egp.ap-hop-paris.fr.
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005260:Female; D005853:Geriatrics; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D017678:Sex Distribution; D016896:Treatment Outcome