Determinants of outcome in elderly patients admitted to the intensive care unit.
BACKGROUND
Age is thought to be strongly associated with intensive care outcomes, but this relationship may be confounded by many clinical variables.


OBJECTIVE
To compare clinical characteristics of elderly patients (> or = 65 years) admitted to the intensive care unit (ICU) with those in younger patients and to identify the risk factors which independently could predict mortality in patients aged > or = 75 years.


METHODS
Prospective observational cohort study.


METHODS
Medical-surgical ICU in a university hospital.


METHODS
2,067 adult patients admitted to the ICU.


METHODS
Comparison of clinical characteristics of patients divided into groups according to their age.


RESULTS
Elderly patients comprised 51% of the study population. Compared with younger patients, elderly patients were more severely ill on admission, had shock and renal dysfunction. The presence of infection on admission and the incidence rate of infection acquired during stay in the ICU also significantly increased with age. Hospital mortality increased with age: for patients aged > or = 75 years, it was more than double that of patients aged <65 years (39% versus 19%, P < 0.001). Using multivariate logistic regression analysis we determined the independent risk factors of hospital mortality for the patients aged > or = 75 years: impaired level of consciousness, infection on admission, ICU-acquired infection and severity of illness score.


CONCLUSIONS
Morbidity and mortality in elderly patients admitted to the ICU are higher than in younger patients. The most important factors independently associated with the highest risk of death are the severity of illness, impaired level of consciousness and infection.
Vosylius
Saulius
S
Clinic of Anaesthesiology and Intensive Care, Vilnius University, Siltnamiu 29, LT-04130 Vilnius-43, Lithuania.
Sipylaite
Jurate
J
Ivaskevicius
Juozas
J
D000367:Age Factors; D000368:Aged; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index