title: Outcome of elderly patients with circulatory failure.
abstract: OBJECTIVE
  The proportion of elderly patients admitted to the ICU is increasing. Mortality rates are known to increase with age but the impact of age on outcomes after circulatory shock has not been well defined.
  
  
  METHODS
  We performed a secondary analysis of data from a large randomized trial comparing the effects of dopamine and norepinephrine on outcome in the ICU. Patients were separated into not old (<75 years), old (75-84 years), and very old (≥85 years).
  
  
  RESULTS
  Of the 1,679 patients included in the initial trial, 1,651 had sufficient age data available: 1,157 (70%) were not old, 410 (25%) were old, and 84 (5%) were very old. There were minor differences among the age groups in the APACHE II score calculated without the age component (not old, 17 ± 9; old, 18 ± 9; very old, 19 ± 9; p = 0.047), but SOFA scores were similar (not old, 9 ± 4; old, 9 ± 3; very old, 9 ± 3; p = 0.76). Mortality rates were higher in old and very old patients at 28 days, at hospital discharge, and after 6 and 12 months. Most very old patients were dead at 6 (92%) and 12 months (97%). Mortality rates increased with age in all types of shock. Using multivariable analysis, the risk of death was higher in very old patients as compared to not old (adjusted OR 0.33, 95% CI 0.2-0.56, p < 0.001).
  
  
  CONCLUSIONS
  Ageing is independently associated with higher mortality rates in patients with circulatory failure, whatever the etiology. By 1 year after admission, most patients 85 years of age and older were dead.
authors.affiliation: Department of Intensive Care, CHU Charleroi, Université Libre de Bruxelles, Charleroi, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Biston
authors.forename: Cesar
authors.initials: C
authors.lastname: Aldecoa
authors.forename: Jacques
authors.initials: J
authors.lastname: Devriendt
authors.forename: Christian
authors.initials: C
authors.lastname: Madl
authors.forename: Didier
authors.initials: D
authors.lastname: Chochrad
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: Daniel
authors.initials: D
authors.lastname: De Backer
mesh_terms: D018806:APACHE; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D017052:Hospital Mortality; D006801:Humans; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D063305:Organ Dysfunction Scores; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D012769:Shock / Q000188:drug therapy / Q000401:mortality*; D015996:Survival Rate; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014662:Vasoconstrictor Agents