[Age as predictive factor of mortality in an intensive and intermediate care unit].
BACKGROUND
Age by itself is not a criterion of biological prognosis. Scores for physiological variables on admission and multiorgan failure are better predictors of mortality.


METHODS
We performed a retrospective/ prospective observational study from September, 2005 to May, 2007. The following variables were analyzed: age, sex, Acute Physiology and Chronic Health Classification System (APACHE) II, modified APACHE II score (without the variable of age), Sequential Organ Failure Assessment (SOFA) score, length of hospital stay, type of disease and mortality, limitation of therapeutic effort (LTE), Katz index on admission, intensive and intermediate care unit (IICU) mortality and in-hospital mortality. Student's t-test was used to analyze continuous variables.


RESULTS
Of the 572 patients admitted to the IICU, we excluded 75 due to transfer to other hospitals, 142 due to direct admission to intermediate care, and 89 due to acute coronary syndrome. Of the 266 remaining patients with medical disease, mortality was higher when the APACHE II score was > 20 (OR = 9.4) and/or the SOFA score was >4 (OR = 15.41) but not when age was 3 76 years (OR = 2.04). Multivariate analysis of these parameters revealed higher mortality in the IICU (P=.01) in patients with a SOFA score > 4 and modified APACHE II score >16, independently of age or the Katz index. In addition to the SOFA and the APACHE II scores, in-hospital mortality was significantly influenced by the Katz index (P=.05). LTE was significantly greater in patients with a Katz index E-G.


CONCLUSIONS
Higher SOFA and APACHE II scores predicted higher IICU mortality, regardless of age. LTE was more frequent in patients with a greater degree of dependence.
Fernández Del Campo
Ricardo
R
Servicio de Cuidados Críticos e Intermedios del Hospital de Hellín, Albacete, España. rfdzdelcampo@hotmail.com
Lozares Sánchez
Amaya
A
Moreno Salcedo
Julio
J
Lozano Martínez
José Ignacio
JI
Amigo Bonjoch
Ricardo
R
Jiménez Hernández
Pedro Antonio
PA
Sánchez Espinosa
José
J
Sarrías Lorenzo
José Angel
JA
Roldán Ortega
Rosa
R
D018806:APACHE; D000367:Age Factors; D000368:Aged; D003422:Critical Care; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies