Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  28 (2024)
Volume  27 (2023)
Volume  26 (2022)
Volume  25 (2021)
Volume  24 (2020)
Volume  23 (2019)
Volume  22 (2018)
Volume  21 (2017)
Volume  20 (2016)
Volume  19 (2015)
Volume  18 (2014)
Volume  17 (2013)
Volume  16 (2012)
Volume  15 (2011)
Volume  14 (2010)
Volume  13 (2009)
Volume  12 (2008)
Volume  11 (2007)
Volume  10 (2006)
Volume  9 (2005)
Volume  8 (2004)
Related articles

VOLUME 25 , ISSUE 6 ( June, 2021 ) > List of Articles

Original Article

Clinical Features and Outcomes of Very Elderly Patients Admitted to the Intensive Care Unit: A Retrospective and Observational Study

Ökkeş H Miniksar, Mikail Özdemir

Citation Information : Miniksar ÖH, Özdemir M. Clinical Features and Outcomes of Very Elderly Patients Admitted to the Intensive Care Unit: A Retrospective and Observational Study. Indian J Crit Care Med 2021; 25 (6):629-634.

DOI: 10.5005/jp-journals-10071-23846

License: CC BY-NC 4.0

Published Online: 01-06-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Background: In this study, we aim to describe clinical features and outcomes of very elderly (85 years old or older) patients and provide information about predictors of mortality and factors associated with the length of hospital stay (LOS). Materials and methods: We reviewed retrospectively the files of patients over 85 years old and older who were admitted to the intensive care unit (ICU) of our training and research hospital between January 2017 and December 2018. Demographic and clinical findings, treatment modalities, and outcomes were recorded. The patients who died during the ICU stay were compared to the survivors, and factors associated with mortality and LOS in the intensive care were evaluated. Results: We reviewed 2350 files, and 218 patients (58.3% females) were included. The rate of mortality was 81.7%. The factors independently associated with a higher rate of mortality were the acute physiology and chronic health evaluation (APACHE) II score; the need for mechanical ventilation (MV), or inotropic support; and the presence of coronary artery disease (CAD) or chronic kidney disease (CKD). A tracheostomy and a blood transfusion were inversely associated with mortality. We found an association between LOS and comorbidities (renal replacement, percutaneous gastrostomy, blood transfusion, and a tracheostomy). Conclusion: The rate of survival in the intensive care was low among these very elderly intensive care patients. A higher APACHE II score; application of MV or inotropic support; and the presence of CAD or CKD were associated with a higher mortality rate.

HTML PDF Share
  1. World Population Prospects. Population division of the department of economic and social affairs of the United Nations Secretariat, the 2019 Revision. Available at: https://population.un.org/wpp/
  2. Elderly Statistics. 2018. Available at: http://www.tuik.gov.tr/PreHaberBultenleri.doid=16057
  3. Lee SH, Lee TW, Ju S, Yoo JW, Lee SJ, Cho YJ, et al. Outcomes of very elderly (≥80 years) critical-ill patients in a medical intensive care unit of a tertiary hospital in Korea. Korean J Intern Med 2017;32(4):675–681. DOI: 10.3904/kjim.2015.331.
  4. Boumendil A, Somme D, Garrouste-Orgeas M, Guidet B. Should elderly patients be admitted to the intensive care unit? Intensive Care Med 2007;33(7):1252–1262. DOI: 10.1007/s00134-007-0621-3.
  5. Nguyen Y-L, Angus DC, Boumendil A, Guidet B. The challenge of admitting the very elderly to intensive care. Ann Intensive Care 2011;1(1):29. DOI: 10.1186/2110-5820-1-29.
  6. Bagshaw SM, Webb SAR, Delaney A, George C, Pilcher D, Hart GK, et al. Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis. Crit Care 2009;13(2):R45. DOI: 10.1186/cc7768.
  7. Ihra GC, Lehberger J, Hochrieser H, Bauer P, Schmutz R, Metnitz B, et al. Development of demographics and outcome of very old critically ill patients admitted to intensive care units. Intensive Care Med 2012;38(4):620–626. DOI: 10.1007/s00134-012-2474-7.
  8. Rellos K, Falagas ME, Sermaides G, Michalopoulos A. Sermaides G, Michalopoulos A. Outcome of critically ill oldest-old patients (aged 90 and older) admitted to the intensive care unit. J Am Geriatr Soc 2006;54(1):110–114. DOI: 10.1111/j.1532-5415.2005.00544.x.
  9. Doğan Baki E, Yüksek A, Bezen BA, Saritaş TB, Sivaci R. Retrospective analysis of anesthesia in geriatric patients during endoscopic retrograde cholangiopancreatography abstract. Turk Geriatr Derg 2018;21(2):225–230. DOI: 10.31086/tjgeri.2018240423.
  10. Fuchs L, Chronaki CE, Park S, Novack V, Baumfeld Y, Scott D, et al. ICU admission characteristics and mortality rates among elderly and very elderly patients. Intensive Care Med 2012;38(10): 1654–1661. DOI: 10.1007/s00134-012-2629-6.
  11. Al-Dorzi HM, Tamim HM, Mundekkadan S, Sohail MR, Arabi YM, Ruokonen E, et al. Characteristics, management and outcomes of critically ill patients who are 80 years and older: a retrospective comparative cohort study. BMC Anesthesiol 2014;14(1):1–9. DOI: 10.1186/1471-2253-14-126.
  12. Reinikainen M, Niskanen M, Uusaro A, Ruokonen E. Impact of gender on treatment and outcome of ICU patients. Acta Anaesthesiol Scand 2005;49(7):984–990. DOI: 10.1111/j.1399-6576.2005.00759.x.
  13. Akın S, Gündoğan K, Coşkun R, Yüksel RC, Topaloğlu US, Öztürk F, et al. Critically ıll elderly patient mortality: ıs age a risk factor? J Med Surg Intensive Care Med 2014;5(2):26–9. DOI: 10.5152/dcbybd.2014.667.
  14. Becker S, Müller J, de Heer G, Braune S, Fuhrmann V, Kluge S. Clinical characteristics and outcome of very elderly patients ≥90 years in intensive care: a retrospective observational study. Ann Intensive Care 2015;5(1):53. DOI: 10.1186/s13613-015-0097-1.
  15. De Rooij SE, Abu-Hanna A, Levi M. Factors that predict outcome of intensive care treatment in very elderly patients: a review Crit Care 2005;9(4):307–314. DOI: 10.1186/cc3536.
  16. Toh HJ, Lim ZY, Yap P, Tang T. Factors associated with prolonged length of stay in older patients. Singapore Med J 2017;58(3):134–138. DOI: 10.11622/smedj.2016158.
  17. Nava S, Grassi M, Fanfulla F, Domenighetti G, Carlucci A, Perren A, et al. Non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure: a randomised controlled trial. Age Ageing 2011;40(4):444–450. DOI: 10.1093/ageing/afr003.
  18. Ferreruela M, Raurich JM, Ayestarán I, Llompart-Pou JA. Hyperlactatemia in ICU patients: ıncidence, causes and associated mortality. J Crit Care 2017;42:200–205. DOI: 10.1016/j.jcrc.2017.07.039.
  19. Rordorf G, Koroshetz W, Efird JT, Cramer SC. Predictors of mortality in stroke patients admitted to an intensive care unit. Crit Care Med 2000;28(5):1301–1305. DOI: 10.1097/00003246-200005000-00007.
  20. Baskin JZ, Panagopoulos G, Parks C, Rothstein S, Komisar A. Clinical outcomes for the elderly patient receiving a tracheotomy. Head Neck 2004;26(1):71–76. DOI: 10.1002/hed.10356.
  21. Hosokawa K, Nishimura M, Egi M, Vincent JL. Timing of tracheotomy in ICU patients: a systematic review of randomized controlled trials. Crit Care 2015;19(1):424. DOI: 10.1186/s13054-015-1138-8.
  22. Marik PE, Corwin HL. Efficacy of red blood cell transfusion in the critically ill: a systematic review of the literature. Crit Care Med 2008;36(9):2667–2674. DOI: 10.1097/CCM.0b013e3181844677.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.