Short-term and long-term mortality in very elderly patients admitted to an intensive care unit.
OBJECTIVE
To report short-term and long-term mortality of very elderly ICU patients and to determine independent risk factors for short-term and long-term mortality


METHODS
Retrospective cohort study in the medical/surgical ICU of a tertiary university teaching hospital.


METHODS
578 consecutive ICU patients aged 80 years or older.


RESULTS
Demographic, physiological, and laboratory values derived from the first 24h after ICU admission. ICU mortality of unplanned surgical (34.0%) and medical patients (37.7%) was higher than that of planned surgical patients (10.6%), as was post-ICU hospital mortality (26.5% and 29.7% vs. 4.4%). Mortality 12 months after hospital discharge, including ICU and hospital mortality, was 62.1% in unplanned surgical and 69.2% in medical patients vs. 21.6% in planned patients. Only median survival of planned surgical patients did not differ from survival in the age- and gender-matched general population. Independent risk factors for ICU mortality were lower Glasgow Coma Scale score, higher SAPS II score, the lowest urine output over 8 h, abnormal body temperature, low plasma bicarbonate levels, and higher oxygen fraction of inspired air. High urea concentrations and admission type were risk factors for hospital mortality, and high creatinine concentration was an independent risk factor for 12-month mortality.


CONCLUSIONS
Mortality in very elderly patients after unplanned surgical or medical ICU admission is higher than after planned admission. The most important factors independently associated with ICU mortality were related to the severity of illness at admission. Long-term mortality was associated with renal function.
de Rooij
S E
SE
Department of Internal Medicine, Academic Medical Center, 22700, 1100 DE, Amsterdam, The Netherlands. s.e.derooij@amc.uva.nl
Govers
A
A
Korevaar
J C
JC
Abu-Hanna
A
A
Levi
M
M
de Jonge
E
E
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013997:Time Factors