title: Outcome of elderly patients who receive intensive care at a regional hospital in Hong Kong.
abstract: OBJECTIVE
  To evaluate the clinical outcome (180-day mortality) of very elderly critically ill patients (age ≥80 years) and compare with those aged 60 to 79 years.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Regional hospital, Hong Kong.
  
  
  METHODS
  Patients aged ≥60 years admitted between 1 January 2009 and 31 December 2013 to the Intensive Care Unit of the hospital.
  
  
  RESULTS
  Over 5 years, 4226 patients aged ≥60 years were admitted (55.5% total intensive care unit admissions), of whom 32.8% were aged ≥80 years. The proportion of patients aged ≥80 years increased over 5 years. As expected, those aged ≥80 years carried more significant co-morbidities and a higher disease severity compared with those aged 60 to 79 years. They required more mechanical ventilatory support, were less likely to receive renal replacement therapy, and had a higher intensive care unit/hospital/180-day mortality compared with those aged 60 to 79 years. Nonetheless, 71.8% were discharged home and 62.2% survived >180 days following intensive care unit admission. Cox regression analysis revealed that Acute Physiology and Chronic Health Evaluation IV-minus-Age score, emergency admission, intensive care unit admission due to cardiovascular problem, neurosurgical cases, presence of significant co-morbidities (diabetes mellitus, metastatic carcinoma, leukaemia, or myeloma), and requirement for mechanical ventilation independently predicted 180-day mortality.
  
  
  CONCLUSIONS
  The proportion of critically ill patients aged ≥80 years increased over a 5-year period. Despite having more significant co-morbidities, greater disease severity, and higher intensive care unit/hospital/180-day mortality rate compared with those aged 60 to 79 years, 71.8% of those ≥80 years could be discharged home and 62.2% survived >180 days following intensive care unit admission. Disease severity, presence of co-morbidities, requirement for mechanical ventilation, emergency cases, and admission diagnosis independently predicted 180-day mortality.
authors.affiliation: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: H P
authors.initials: HP
authors.lastname: Shum
authors.affiliation: Department of Anaesthesia and Intensive Care, Tuen Mun Hospital, Tuen Mun, Hong Kong.
authors.forename: K C
authors.initials: KC
authors.lastname: Chan
authors.affiliation: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: H Y
authors.initials: HY
authors.lastname: Wong
authors.affiliation: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: W W
authors.initials: WW
authors.lastname: Yan
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003422:Critical Care / Q000706:statistics & numerical data*; D016638:Critical Illness / Q000401:mortality* / Q000628:therapy; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D063868:Patient Outcome Assessment; D016016:Proportional Hazards Models; D017582:Renal Replacement Therapy / Q000401:mortality; D012121:Respiration, Artificial / Q000401:mortality
keywords: Aged, 80 and over; Intensive care; Mortality; Treatment outcome