Outcome of older critically ill patients: a matched cohort study.
BACKGROUND
Admission of older patients to intensive care units is a controversial issue.


OBJECTIVE
To estimate age-associated mortality of critically ill patients.


METHODS
A prospective matched cohort study in the Medical-Surgical Intensive Care Unit of a tertiary hospital was conducted. We included 100 consecutive patients older than 70 years admitted to the intensive care unit (cases) and 100 patients younger than 70 years (controls). The matching criterion was the severity of illness at admission to the intensive care unit as estimated by the simplified acute physiological score (SAPS II) without including age in its calculation.


RESULTS
Mortality in the intensive care unit was higher, but not statistically significant, in the older group: 26% vs. 19% (p = 0.23). Patients older than 70 years had a longer duration of mechanical ventilation (median 7 vs. 3 days) and longer stay in the intensive care unit (median 8 vs. 5 days). There were no differences in organ dysfunctions, except for a higher incidence of respiratory failure in the older group (p < 0.001). The use of invasive procedures was similar in both groups. There were more orders for the withholding/withdrawal of treatment in patients older than 70 years (9 vs. 3%, p = 0.07).


CONCLUSIONS
In our study, age was not related with a significant higher mortality. In the older patients included in our study the survival was greater than 70% with a similar resource utilization except for a longer stay in the intensive care unit.
Rodríguez-Regañón
Inmaculada
I
Department of Geriatrics, Hospital Universitario de Getafe, Madrid, Spain.
Colomer
Isabel
I
Frutos-Vivar
Fernando
F
Manzarbeitia
Jorge
J
Rodríguez-Mañas
Leocadio
L
Esteban
Andrés
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012121:Respiration, Artificial