Pattern and outcome of elderly admissions into the Intensive Care Unit (ICU) of a low resource tertiary hospital

Abstract

Background: Globally, the population of the elderly is increasing and the greatest increase is occurring in the developing and middle income countries because of falling death rate and high birth rate. The ageing of the population in developing countries may result in increasing requirement for health care facilities including ICU care for the elderly. This study was aimed at assessing the pattern and outcome of elderly patients' admissions into the ICU of our hospital and identifies the determinants of outcome. Method: This was a retrospective study covering a 5 year period (January1 st 2010 to 31 st December 2014) in the ICU of a sub-Saharan tertiary hospital. Data was obtained from the review of ICU admission records over this period. We included as elderly patients aged 65years and above. Results: During the period under review, 90 cases were identified but only 62 cases were available for review (68.9%). There were 40 males and 22 females with ages ranging between 65 and 92years. Surgical admissions accounted for 75.8% of admissions while medical admissions were 24.2%. The overall ICU mortality in the elderly was 58.1%.The major predictors of mortality were: need for endotracheal intubation (p=0.001), mechanical ventilation (p=0.001), vasopressor (p=0.001), electrolyte derangement (p=0.001), sepsis on admission (p=0.001), shock on admission (p=0.001). Conclusion: Elderly patients admitted into the ICU are a population with an increased risk of mortality. The predictors of high risk of death are sepsis on admission, septic shock, need for vasopressor, endotracheal intubation and or mechanical ventilation and the presence of electrolyte derangement. The outcome of this study calls for a need to pay more attention to this rapidly expanding group of the population.

Inhospital outcome of elderly patients in an intensive care unit in a Sub-Saharan hospital

“…This retrospective study found that elderly patients represented 11.2% of admissions to ICU. This rate is comparable to the (10%) of Owojuyigbe et al [ 8 ] and the (16.6%) of Belayachi et al [ 9 ]. In developed countries elderly admissions rate to ICU was high.…”

Inhospital Outcome of Elderly Patients in an Intensive Care Unit in a Sub-Saharan Hospital

“…The mean age (71.7) in this study was comparable to Owojuyigbe et al [6] report (73 years) and Belayachi et al [8] report (72 years). In Porto, Abelha et al [10] reported 64.1 years.…”

“…Older patients accounted for 11.2% of ICU admission. This rate is comparable to the 10% of Owojuyigbe et al [6] findings in Nigeria but less than the findings in the United States (42-52%). Better health-care system organization, life expectancy improvement explains high prevalence in developed countries.…”

“…Our findings are different with Belayachi et al [8] who found that respiratory infections were most predominant. Diagnoses vary according to study, social environment, and countries [6,8,11,14]. Advanced age alone does not preclude successful outcome [9].…”

Factors Associated with the Outcome of Older Patients Admitted in Geriatric Intensive Care Unit

“…In similar studies done in Nigeria, Morocco and Brasilia, the mean age was 73 years, 72 years and 75.4±6.8 years respectively. 5,6,7 Age in and of itself is not a predictor of mortality from critical illness. 2 ICU care may provide the most significant benefit to older adults.…”