title: Age differences in survival outcomes and resource use for chronically critically ill patients.
abstract: OBJECTIVE
  Chronically critically ill (CCI) patients use a disproportionate amount of resources, yet little research has examined outcomes for older CCI patients. The purpose of this study was to compare outcomes (mortality, disposition, posthospital resource use) between older (> or =65 years) and middle-aged (45-64 years) patients who require more than 96 hours of mechanical ventilation while in the intensive care unit.
  
  
  METHODS
  Data from 2 prospective studies were combined for the present examination. In-hospital as well as posthospital discharge data were obtained via chart abstraction and interviews.
  
  
  RESULTS
  One thousand one hundred twenty-one subjects were enrolled; 62.4% (n = 700) were older. Older subjects had a 1.3 greater risk for overall mortality (from admission to 4 months posthospital discharge) than middle-aged subjects. The Acute Physiology Score (odds ratio [OR], 1.009), presence of diabetes (OR, 2.37), mechanical ventilation at discharge (OR, 3.17), and being older (OR, 2.20) were statistically significant predictors of death at 4 months postdischarge. Older subjects had significantly higher charges for home care services, although they spent less time at home (mean, 22.1 days) than middle-aged subjects (mean, 31.3 days) (P = .03).
  
  
  CONCLUSIONS
  Older subjects were at higher risk of overall mortality and used, on average, more postdischarge services per patient when compared with middle-aged subjects.
authors.affiliation: Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106-4904, USA. sara.douglas@case.edu
authors.forename: Sara L
authors.initials: SL
authors.lastname: Douglas
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Daly
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: O'Toole
authors.forename: Carol G
authors.initials: CG
authors.lastname: Kelley
authors.forename: Hugo
authors.initials: H
authors.lastname: Montenegro