Influence of patients' age on survival, level of therapy and length of stay in intensive care units

Abstract

The influence of patients' age on survival, level of therapy and length of stay was analyzed from data collected in 792 consecutive admissions to eight intensive care units. Mortality rate increased progressively with age; over 65 years of age, it was more than double that of patients under 45 years (36.8% versus 14.8%). However, mortality rate in patients over 75 years was equal to that observed in the 55 to 59 years group. There was a significant relationship between age and acute physiology score (APS) and the influence of age upon outcome decreased when APS increased. The number of TISS (therapeutic intervention scoring system) points delivered to patients increased slightly but significantly with age (r = 0.14). Standard care was responsible for the main part of this increase. Both in survivors and in non-survivors the length of stay was not different comparing the stay of the oldest patient with that of the younger age groups. We conclude that, in ICU patients, age is an important factor of prognosis but not as important as the severity of illness, and that there is no major difference in outcome of patients over 65 years of age compared to the entire study group of ICU patients.

Evaluation of the effect of intensity of care on mortality after traumatic brain injury

“…Another recent systematic review in critically ill elders found that with appropriate adjustment for other confounders in addition to age, the effect of the latter was greatly reduced (13). When ascertaining mortality risk of older adults after critical illness, severity of illness seems to be the more important prognostic indicator (13)(14)(15)(16)(17)(18)(19). Other variables shown to affect mortality rates among critically ill older adults include chronic health conditions, mechanical ventilation, pulmonary artery (PA) catheterization, complications, residing in a nursing home, preadmission functional ability, sex, and ethnicity (12,(20)(21)(22).…”

Intensive care requirements for an ageing population – a microcosm of problems facing the NHS?

“…14 Even though ICU mortality increases with age, older patients do benefit from ICU admission because severity of illness is a more important factor. 3,[15][16][17][18] ICU mortality for those aged >65 years has been reported as 36.8% 3 and survival of 70-to 84-year-olds at one year following intensive care is as high as 56%. 15 However, these figures are worse in those aged over 85 years, where survival at one year is 23%.…”

“…2 However, under 85 years, age per se does not predict poor outcome after intensive care unit (ICU) admission. 3 Today's society is less willing to accept barriers to treatment and the older population is, and is likely to become still more vocal in its demands for equal access.…”

Morbimortalidad de pacientes mayores de 60 años en el servicio de cuidados intensivos de un hospital general.

“…Nuestros hallazgos sobre la intensidad del manejo del paciente mayor en la UCI concuerdan con lo encontrado en la literatura extranjera, donde se aprecia que a mayor edad los pacientes requieren más soporte ventilatorio, inotrópico y dialítico, debido a la mayor frecuencia de pacientes con comorbilidad y enfermedades crónicas (14,15).…”