title: Risk factors for hospital and long-term mortality of critically ill elderly patients admitted to an intensive care unit.
abstract: BACKGROUND
  Data on long-term outcomes of elderly (≥65 years) patients in ICU are sparse.
  
  
  METHODS
  Adult patients (n = 1563, 45.4% elderly) admitted over 28 months were analyzed by competing risks regression model to determine independent factors related to in-hospital and long-term mortality.
  
  
  RESULTS
  414 (26.5%) and 337 (21.6%) patients died in-hospital and during the 52 months following discharge, respectively; the elderly group had higher mortality during both periods. After discharge, elderly patients had 2.3 times higher mortality compared to the general population of the same age-group. In-hospital mortality was independently associated with mechanical ventilation (subdistribution hazard ratio (SHR) 2.74), vasopressors (SHR 2.56), neurological disease (SHR 1.77), and Mortality Prediction Model II score (SHR 1.01) regardless of age and with malignancy (SHR, hematological 3.65, nonhematological 3.4) and prior renal replacement therapy (RRT, SHR 2.21) only in the elderly. Long-term mortality was associated with low hemoglobin concentration (SHR 0.94), airway disease (SHR 2.23), and malignancy (SHR hematological 1.11, nonhematological 2.31) regardless of age and with comorbidities especially among the nonelderly.
  
  
  CONCLUSIONS
  Following discharge, elderly ICU patients have higher mortality compared to the nonelderly and general population. In the elderly group, prior RRT and malignancy contribute additionally to in-hospital mortality risk. In the long-term, comorbidities (age-related), anemia, airway disease, and malignancy were significantly associated with mortality.
authors.affiliation: Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Health System, Singapore ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: A
authors.initials: A
authors.lastname: Mukhopadhyay
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
authors.forename: B C
authors.initials: BC
authors.lastname: Tai
authors.affiliation: Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Health System, Singapore ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: K C
authors.initials: KC
authors.lastname: See
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
authors.forename: W Y
authors.initials: WY
authors.lastname: Ng
authors.affiliation: Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Health System, Singapore ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: T K
authors.initials: TK
authors.lastname: Lim
authors.affiliation: The University of Sheffield, Sheffield, UK.
authors.forename: S
authors.initials: S
authors.lastname: Onsiong
authors.affiliation: National University of Singapore, Singapore.
authors.forename: S
authors.initials: S
authors.lastname: Ee
authors.affiliation: National University of Singapore, Singapore.
authors.forename: M J
authors.initials: MJ
authors.lastname: Chua
authors.affiliation: National University of Singapore, Singapore.
authors.forename: P R
authors.initials: PR
authors.lastname: Lee
authors.affiliation: National University of Singapore, Singapore.
authors.forename: M L
authors.initials: ML
authors.lastname: Loh
authors.affiliation: Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Health System, Singapore ; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: J
authors.initials: J
authors.lastname: Phua
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D012307:Risk Factors