title: Elderly patients hospitalized in the ICU in France: a population-based study using secondary data from the national hospital discharge database.
abstract: OBJECTIVE
  In the global context of population ageing, understanding and monitoring intensive care use by the elderly is a strategic issue. National-level data are needed to overcome sampling biases that often limit epidemiologic studies of the critically ill elderly. The objective of this study was to describe intensive care use for hospitalized elderly patients using secondary data from the French national hospital discharge database.
  
  
  METHODS
  Structured assessment of the national database coverage and accuracy; cross-sectional analysis of hospitalizations including at least one admission in an intensive care unit (ICU) for patients aged ≥ 80 years from 1 January to 31 December 2009.
  
  
  RESULTS
  In 2009, people aged ≥ 80 years accounted for 5.4% of the population but 15.3% of the 215 210 adult hospitalizations involving intensive care in France. In this elderly group, the mean age was 84.0 (± 3.56) years, and 51.6% were male. In-hospital mortality was 33.9%. The median time spent in the ICU was 3 [interquartile range (IQR), 2-8] days, the median time spent in hospital was 14 (IQR, 8-24) days and 9% of hospitalizations ended by the patient's death involved intensive care. A surgical procedure was included in 43% of hospitalizations. Medical and surgical diagnosis-related group hospitalizations were characterized by significant differences in volume, mortality, ICU days and costs.
  
  
  CONCLUSIONS
  There was marked clinical heterogeneity in the population of elderly patients hospitalized in the ICU. These data provide baseline information and prompt further studies comparing intensive care utilization across age groups, between countries and over time.
authors.affiliation: EAM 4128 Santé - Individu - Société, Université de Lyon, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fassier
authors.affiliation: EAM 4128 Santé - Individu - Société, Université de Lyon, France.|Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Duclos
authors.affiliation: Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France.
authors.forename: Fatima
authors.initials: F
authors.lastname: Abbas-Chorfa
authors.affiliation: Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Couray-Targe
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, WA, 98104, USA.
authors.forename: T Eoin
authors.initials: TE
authors.lastname: West
authors.affiliation: Service de Réanimation Médicale, Hospices Civils de Lyon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Argaud
authors.affiliation: EAM 4128 Santé - Individu - Société, Université de Lyon, France.|Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Colin
mesh_terms: D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D005602:France; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D010351:Patient Discharge
keywords: France; aged 80 and older; cross-sectional studies; diagnosis-related groups (DRG); health services research; intensive care units (ICU)