title: Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit.
abstract: BACKGROUND
  Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU.
  
  
  METHODS
  A single-center, prospective, observational study was carried out among geriatric patients, aged 75 years or older, admitted to ICU.
  
  
  RESULTS
  A total of 71 patients were admitted to ICU during the study period. Their mean age was 83 years (range 75-98 years), with a mean Acute Physiology and Chronic Health Evaluation-II score of 21.8 (range 8-39) on admission to ICU. A total of 48 patients (68%) required mechanical ventilation, and 39 (55%) received at least one vasoactive drug. The mean ICU length of stay was 4.6 days (range 1-18 days), and it was similar for ICU survivors and non-survivors (4.7 vs 4.5). A total of 14 patients (19.7%) were admitted after cardiac arrest, and eight (57.1%) of them died in ICU. A total of 28 patients (39.4%) died in the hospital, and 18 (25.4%) died in ICU.
  
  
  CONCLUSIONS
  Advanced age, critical illness, cardiopulmonary resuscitation, and needs for mechanical ventilation and/or vasopressor therapy are independent risk factors associated with adverse outcome in elderly patients admitted to ICU. Alternatives for ICU admission should be considered in geriatric patients with severe critical illnesses.
authors.affiliation: Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.
authors.forename: Jose
authors.initials: J
authors.lastname: Orsini
authors.affiliation: Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.
authors.forename: Ashvin
authors.initials: A
authors.lastname: Butala
authors.affiliation: Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.
authors.forename: Say
authors.initials: S
authors.lastname: Salomon
authors.affiliation: Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Studer
authors.affiliation: Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.
authors.forename: Shardul
authors.initials: S
authors.lastname: Gadhia
authors.affiliation: Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.
authors.forename: Ben
authors.initials: B
authors.lastname: Shamian
authors.affiliation: Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Prajapati
authors.affiliation: Department of Medicine, New York University School of Medicine, Woodhull Medical and Mental Health Center, New York, New York, USA.
authors.forename: Christa
authors.initials: C
authors.lastname: Blaak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000639:trends; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
keywords: critically ill; elderly patients; geriatric medicine; intensive care unit; quality of life