title: Cardiovascular profile in critically ill elderly medical patients: prevalence, mortality and length of stay.
abstract: OBJECTIVE
  Data are demonstrating the increase in utilization of critical care by the elderly. Around 11% of ICU patients are ≥80years-old.
  
  
  METHODS
  An observational retrospective study was conducted between 2003 and 2011, including elderly patients (≥80years old) admitted from medical services to the intensive care unit (ICU) in a tertiary university hospital. The final sample size was N=202.
  
  
  RESULTS
  Mortality rates were: ICU 34.1%, in-hospital 44% and 1-year cumulative mortality 55.4% (20.4% for hospital survivors). Multivariate analysis showed that APACHE II score: OR 1.10, 95% CI (1.03-1.18), SAPS II score: OR 1.03, 95% CI (1.01-1.06), a score <3 on the Cruz Roja Hospital mental scale: 0.51 OR, 95% CI (0.01-0.57) and ICU admission for cardiovascular disease: OR 5.05, 95% CI (1.98-12.84) were independently associated with mortality ICU. Factors independently associated with 1-year mortality were: dyslipidemia OR 7.25 (1.47-35.60), chronic kidney failure OR 13.23, 95% CI (2.28-76.6), stroke OR 10.44, 95% CI (2.26-48.25) and antihypertensive treatment OR 0.08, 95% CI (0.01-0.48). In multiple linear regression, ICU length of stay was associated with mechanical ventilation B coefficient 6.41, 95% CI (1.18-11.64) and in-hospital length of stay was related to age: B coefficient -2.17, 95% CI (-4.02 to -0.33).
  
  
  CONCLUSIONS
  Prevalence of cardiovascular risk factors and cardiovascular disease was high, and basal cardiovascular treatment was underused. Primary diagnosis for cardiovascular disease at ICU admission should be assessed as predictor of ICU mortality. Intensifying cardiovascular basal treatment could decrease 1-year mortality. Cardiovascular profile did not show an effect on in-hospital mortality and length of stay.
authors.affiliation: Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: rpuchades@gmail.com.
authors.forename: Ramón
authors.initials: R
authors.lastname: Puchades
authors.affiliation: Intensive Care Unit, La Princesa University Hospital, Madrid, Spain. Electronic address: gmbego@gmail.com.
authors.forename: Begoña
authors.initials: B
authors.lastname: González
authors.affiliation: Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: sagu_4@hotmail.coma.
authors.forename: Mar
authors.initials: M
authors.lastname: Contreras
authors.affiliation: Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: alexah_go@hotmail.com.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Gullón
authors.affiliation: Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: asor33@hotmail.com.
authors.forename: Rosa
authors.initials: R
authors.lastname: de Miguel
authors.affiliation: Internal Medicine Service, La Princesa University Hospital, Madrid, Spain. Electronic address: daniprote@gmail.coma.
authors.forename: Daniel
authors.initials: D
authors.lastname: Martín
authors.affiliation: Preventive Medicine Service, Gómez-Ulla University Hospital, Madrid, Spain. Electronic address: kargut13@gmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gutiérrez
authors.affiliation: Anesthesiology and Resuscitation Service, Gómez-Ulla University Hospital, Madrid, Spain. Electronic address: r_navarro_suay@yahoo.es.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Navarro
mesh_terms: D018806:APACHE; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D016638:Critical Illness / Q000453:epidemiology / Q000401:mortality; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents
keywords: Cardiovascular disease; Critical care; Elderly; Length of stay; Mortality