title: Risk factors for death among critically ill elderly patients.
abstract: BACKGROUND
  The elderly population is increasing all over the world. The need of intensive care by the elderly is also increasing. There is a lack of studies investigating the risk factors for death among critically ill elderly patients. This study aims to investigate the factors associated with death in a population of critically ill elderly patients admitted to an intensive care unit in Brazil.
  
  
  METHODS
  This is a retrospective cohort study including all elderly patients (>60 years) admitted to an intensive care unit in Fortaleza, Brazil, from January to December 2007. A comparison between survivors and nonsurvivors was done and the risk factors for death were investigated through univariate and multivariate analysis.
  
  
  RESULTS
  A total of 84 patients were included, with an average age of 73 ± 7.6 years; 59% were female. Mortality was 62.8%. The main cause of death was multiple organ dysfunction (42.3%), followed by septic shock (36.5%) and cardiogenic shock (9.7%). Complications during intensive care unit ICU stay associated with death were respiratory failure (OR=61, p<0.001), acute kidney injury (OR=23, p<0.001), sepsis (OR=12, p<0.001), metabolic acidosis (OR=17, p<0.001), anemia (OR=8.6, p<0.005), coagulation disturbance (OR=5.9, p<0.001) and atrial fibrillation (OR=4.8, p<0.041). Independent risk factors for death were age (OR=1.15, p<0.005), coma (OR=7.51, p<0.003), hypotension (OR=21.75, p=0.003), respiratory failure (OR=9.93, p<0.0001) and acute kidney injury (OR=16.28, p<0.014).
  
  
  CONCLUSIONS
  Mortality is high among critically ill elderly patients. Factors associated with death were age, coma, hypotension, respiratory failure and acute kidney injury.
authors.affiliation: Escola de Saúde Pública do Ceará, Fortaleza, CE, Brasil.
authors.forename: Gisele Collyer
authors.initials: GC
authors.lastname: Alves
authors.affiliation: Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Geraldo Bezerra da
authors.initials: GB
authors.lastname: Silva Júnior
authors.affiliation: Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: Rafael Siqueira Athayde
authors.initials: RS
authors.lastname: Lima
authors.affiliation: Hospital Geral de Fortaleza, Fortaleza, CE.
authors.forename: Juliana Barbosa
authors.initials: JB
authors.lastname: Sobral
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Rosa Maria Salani
authors.initials: RM
authors.lastname: Mota
authors.affiliation: Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Krasnalhia Lívia Soares de
authors.initials: KL
authors.lastname: Abreu
authors.affiliation: Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Natália Albuquerque
authors.initials: NA
authors.lastname: Rocha
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Charlys Barbosa
authors.initials: CB
authors.lastname: Nogueira
authors.affiliation: Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Elizabeth De Francesco
authors.initials: Ede F
authors.lastname: Daher