title: Trends in hospital and intensive care admissions in the Netherlands attributable to the very elderly in an ageing population.
abstract: BACKGROUND
  The Dutch population is ageing and it is unknown how this is affecting trends in the percentage of hospital and intensive care unit (ICU) admissions attributable to patients aged 80 years or older, the very elderly.
  
  
  METHODS
  We present data on the percentage of the very elderly in the general population and the percentage of hospital admissions attributable to the very elderly. We subsequently performed a longitudinal cross-sectional study on ICU admissions from hospitals participating in the National Intensive Care Evaluation registry for the period 2005 to 2014. We modeled the percentage of adult ICU admissions and treatment days attributable to the very elderly separately for ICU admissions following cardiac surgery and other reasons.
  
  
  RESULTS
  The percentage of Dutch adults aged 80 years and older, increased from 4.5 % in 2005 to 5.4 % in 2014 (p-value < 0.0001) and with this ageing of the population, the percentage of hospital admissions attributable to very elderly increased from 9.0 % in 2005 to 10.6 % in 2014 (p-value < 0.0001). The percentage of ICU admissions following cardiac surgery attributable to the very elderly increased from 6.7 % in 2005 to 11.0 % in 2014 in nine hospitals (p-value < 0.0001), while the percentage of treatment days attributable to this group rose from 8.6 % in 2005 to 11.7 % in 2014 (p-value = 0.0157). In contrast, the percentage of very elderly patients admitted to the ICU for other reasons than following cardiac surgery remained stable at 13.8 % between 2005 and 2014 in 33 hospitals (p-value = 0.1315). The number of treatment days attributable to the very elderly rose from 11,810 in 2005 to 15,234 in 2014 (p-value = 0.0002), but the percentage of ICU treatment days attributable to this group remained stable at 12.0 % (p-value = 0.1429).
  
  
  CONCLUSIONS
  As in many European countries the Dutch population is ageing and the percentage of hospital admissions attributable to the very elderly rose between 2005 and 2014. However, the percentage of ICU admissions and treatment days attributable to very elderly remained stable. The percentage of ICU admissions following cardiac surgery attributable to this group increased between 2005 and 2014.
authors.affiliation: Department of Intensive Care Medicine, Diakonessenhuis, PO box 80250, 3508, TG, Utrecht, The Netherlands. lvlelyveld@diakhuis.nl.
authors.forename: Lenneke E M
authors.initials: LE
authors.lastname: Haas
authors.affiliation: Department of Intensive Care Medicine, Diakonessenhuis, PO box 80250, 3508, TG, Utrecht, The Netherlands. akarakus@diakhuis.nl.
authors.forename: Attila
authors.initials: A
authors.lastname: Karakus
authors.affiliation: NICE foundation, Amsterdam, The Netherlands. r.holman@amc.uva.nl.|Amsterdam Medical Centre, Department of Medical Informatics, Amsterdam, The Netherlands. r.holman@amc.uva.nl.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Holman
authors.affiliation: Dutch Hospital Data, Utrecht, The Netherlands. cihangir@hospitaldata.eu.
authors.forename: Sezgin
authors.initials: S
authors.lastname: Cihangir
authors.affiliation: NICE foundation, Amsterdam, The Netherlands. reidinga@mac.com.|Department of Intensive Care, Martini Hospital, Groningen, The Netherlands. reidinga@mac.com.
authors.forename: Auke C
authors.initials: AC
authors.lastname: Reidinga
authors.affiliation: NICE foundation, Amsterdam, The Netherlands. n.f.keizer@amc.uva.nl.|Amsterdam Medical Centre, Department of Medical Informatics, Amsterdam, The Netherlands. n.f.keizer@amc.uva.nl.
authors.forename: Nicolette F
authors.initials: NF
authors.lastname: de Keizer
mesh_terms: D000369:Aged, 80 and over; D000375:Aging; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data / Q000639:trends*; D007902:Length of Stay; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends*